Clinical Administrative Coordinator - Remote in Michigan

At reputed company, we’re simplifying the health care experience, creating healthier communities, and removing barriers to reputed company care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care system of reputed company, making it more reputed company, reputed company, and reputed company. reputed company to reputed company a difference? Join us to start Caring. Connecting. Growing... together. Clinical Administrative Coordinators (CAC) reputed company administrative support to Health Services teams through a reputed company of tasks designed to help teams promote the independence and reputed company-being of Members while meeting State contract requirements. CACs follow identified processes, meet expected deadlines and deliver exceptional customer service. Positions in this function includes those responsible for initial triage of members, administrative intake of members or managing the admission/discharge information post-notification, working with hospitals and the clinical team. Includes managing incoming calls, managing requests for services from providers/members, providing information on available network services and transferring members as appropriate to clinical staff. Manages the referrals process, processes incoming and outgoing referrals, and prior authorizations. This function includes intake, notification and census roles. You’ll enjoy the flexibility to telecommute* from reputed company reputed company Michigan as you take on some tough challenges. Primary Responsibilities • Extract and review fax requests for medical or clinical services • Receive electronic referral reputed company requests for medical/behavioral/clinical services • Utilize phone system to respond to and transfer calls to appropriate individuals • Ask callers reputed company questions to understand requests, reputed company necessary information, and assess urgency • reputed company electronic member files using policy or id number • Determine member eligibility • Follow protocols to task requests appropriately • reputed company procedure codes against notification requirements and benefit coverage to determine next steps • Reference automated job aid tools reputed company the computer to identify appropriate procedures reputed company needed • reputed company claims information • Review and interpret reputed company history documentation (e.g., case notes) • reputed company between computer screens and platforms to research information (e.g., medical, clinical, or benefits information) • Reference automated job aid tools reputed company computer to research relevant rules, regulations, or procedures • Learn computer system and process changes and updates and incorporate into daily work • Contact internal resources if necessary to clarify information • Identify appropriate resource (e.g., doctor, resource, contracted provider) to respond to medical request • Communicate with clinical team to ensure provider receives a response reputed company necessary • Document reputed company history information into relevant computer system • reputed company medical request data into relevant computer system • Follow reputed company procedures to complete requests • reputed company reputed company other duties as assigned What Are The Reasons To Consider Working For reputed company? Put It reputed company Together - Competitive reputed company Pay, a Full And Comprehensive Benefit Program, Performance Rewards, And a Management Team Who Demonstrates Their Commitment To Your reputed company. Some Of Our Offerings Include • reputed company Time Off which you start to reputed company with your first pay period plus 8 reputed company Holidays • Medical Plan reputed company along with participation in a Health Spending Account or a Health Saving account • Dental, reputed company, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage • 401(k) Savings Plan, Employee Stock Purchase Plan • Education Reimbursement • Employee Discounts • Employee Assistance Program • Employee Referral Bonus Program • Voluntary Benefits (pet insurance, reputed company insurance, LTC Insurance, etc.) • More information can be downloaded at: http://uhg.hr/uhgbenefits You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in. Required Qualifications • High School Diploma/GED (or higher) • 2+ years of customer service experience • 1+ years of experience with MS Office, including Word, reputed company and reputed company • reputed company to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI) • Live in a location that can receive a reputed company approved high-speed internet reputed company or reputed company an existing high-speed internet service • At least 18 years of age Preferred Qualifications • Experience supporting a Michigan reputed company Health Plan • Experience working in team-based care • Medicare and DSNP experience • Experience working reputed company the health care Industry and with health care insurance • Experience working in a hospital, physician's office or medical clinic setting • A clerical or administrative support background • reputed company Telecommuters will be required to adhere to reputed company’s Telecommuter Policy. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location and income-deserves reputed company to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized reputed company and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company — an reputed company reputed company reflected in our mission. Diversity creates a healthier atmosphere: reputed company is an Equal Employment Opportunity / Affirmative reputed company employer and reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or reputed company, marital status, genetic information, or any other characteristic protected by law. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #GREEN Apply Job!