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Associate Patient Care Coordinator

3 months ago

Las Vegas, United States UnitedHealth Group Full time

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. 

The Associate Patient Care Coordinatoris responsible for the completion of set processes and protocols, working cooperatively with all members of the care team to support the vision and mission of the organization, delivering excellent customer service and adhering to Lean processes, and supporting the teams in meeting financial, clinical and service goals.

Schedule: Monday – Friday, 8:00AM – 5:00PM

Location: Goldring Ave, Las Vegas, NV

Primary Responsibilities:

Provide high level of customer service while communicating with internal departments and external provider office staff as pertains to performance of job duties Review and process prior authorization requests to meet departmental key indicator productivity Verifies patient insurance eligibility & benefits to include applicable co-pays, co-insurances, deductibles, Out of Pocket Maximum, appropriate service facilities, services covered and which services if any require prior authorization Demonstrate knowledge of insurances including navigating websites for online benefit reviews Answer incoming calls regarding benefits, eligibility, authorizations & referrals as well as other inquiries as it relates to health insurance and acts as Patient Advocate Process adverse determinations; timely notification and thorough documentation Respond to complex customer calls Resolve customer service inquiries which could include: Benefit and Eligibility information Authorization for treatment Specialists Orders/Referrals Must be able to work independently Submit Specialists Referrals with appropriate clinical information using established protocols & procedures Exceed attendance standards set by company policy Take responsibility of problem solving Any other duties that may arise

What are the reasons to consider working for UnitedHealth Group? Put it all together – competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

Paid Time Off which you start to accrue with your first pay period plus 8 Paid HolidaysMedical Plan options along with participation in a Health Spending Account or a Health Saving accountDental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage(k) Savings Plan, Employee Stock Purchase PlanEducation ReimbursementEmployee DiscountsEmployee Assistance ProgramEmployee Referral Bonus ProgramVoluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)More information can be downloaded at: You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

High school diploma / GED (or higher) 1+ years of customer service experience1+ years of experience with insurance programs and basic managed care principles such as referrals and prior authorization1+ years of experience with Nevada health insurance terminologyIntermediate level of proficiency in MS Word, Excel, and Outlook, including the ability to use multiple web applications

Preferred Qualifications:

1+ years of experience in a health care settingKnowledge/understanding of CPT/ICD-10 codingAbility to work in an office setting with patient contact during shiftExperience in a high-volume medical clinicWork experience in UrologyKnowledge of local HMO/PPO/Medicare plansBilingual (English/Spanish)

Soft Skills:

Excellent communication skills and phone etiquette

Nevada Residents Only: The hourly range for Nevada residents is $16.00 to $28.27 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable.In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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