Correspondence UM Coordinator – National Remote

Opportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you discover the meaning behind Caring. Connecting. Growing together.

 

This position is 4 days, 10 hours shift, Wednesday – Saturday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am – 7:00 pm CST. It may be necessary, given the business need, to work occasional overtime or weekends.

 

We offer weeks of on-the-job training. The hours of the training will be based on schedule or will be discussed on your first day of employment.

 

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

 

Primary Responsibilities:

• Process UM notification according to standard operating procedures and job aids while meeting productivity and quality standards to include:
• TruCare queues
• Information received through Right Fax
• Information received through email
• Or any other methods of receipt (phone calls, etc.)
• Process the correct health plan letters in the system of record, if applicable verify grade level
• Process the correct health plan letters manually and document in the system of record
• Process the correct health plan letter in the preferred language
• Process overnight labels for the letters when applicable
• Process return mail retrieved from the mailroom
• Process Health Plan and QIO appeals
• Exhibits excellent communication skills while providing complete and accurate information to customers
• Requests additional or supplemental information via correspondence in order to complete UM notification requests
• Prepares administrative files for Medical Directors, UM Nurses and Case Managers
• Documents and follows-up on all assigned inventory, utilizing on-line systems and procedures, according to established guidelines 
• Maintains knowledge of various health plan partner benefits, networks, CMS regulations and health plan partner policies
• Utilize experience and judgement to plan, accomplish goals and effectively resolve each assigned task
• Print, feed, and retrieve letters from the folding machine
• Metered mail is handled according to processes and procedures
• Attends required meetings and participates in special committees as needed
• Performs all other related duties as assigned 

In 2011, WellMed partnered with Optum to provide care to patients across Texas and Florida. WellMed is a network of doctors, specialists and other medical professionals that specialize in providing care for more than 1 million older adults with over 16,000 doctors’ offices. At WellMed our focus is simple. We’re innovators in preventative health care, striving to change the face of health care for seniors. WellMed has more than 22,000+ primary care physicians, hospitalists, specialists, and advanced practice clinicians who excel in caring for 900,000+ older adults. Together, we’re making health care work better for everyone.

 

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)
• Must be 18 years of age or older
• 2+ years of administrative support experience
• 6+ months of knowledge / experience with medical terminology
• Intermediate level of proficiency with Microsoft Office applications, i.e., Microsoft Excel, Access, Microsoft Word, and Microsoft Outlook
• Ability to work 4 days, 10 hours schedule, Wednesday – Saturday between the hours of 8:00 am – 7:00 Pm), It may be necessary, given the business need, to work occasional overtime or weekends.

  

Preferred Qualifications:  

• Certified Medical Assistant training or certification
• 2+ years of experience with prior authorization or claims
• ICD-9/ICD-10 and CPT knowledge

 

Telecommuting Requirements:

• Ability to keep all company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.

 

Soft Skills: 

• Proven ability to work independently, with some supervision and direction from manager
• Proven exceptional ability to organize, prioritize and communicate effectively
• Proven ability to provide excellent customer service to a varied customer base
• Proven ability to navigate multiple systems
• Proven ability to work in a fast-paced environment

 

 

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy  

  

The hourly range for this role is $16.88 to $33.22 per hour based on full-time employment. 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 401k 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.

 

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

 

At OptumCare 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.

 

 

OptumCare Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

 

 

 

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

 

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