- All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
- Documents all patient interactions in a concise manner that is compliant with documentation requirements for Model of Care, NCQA and Center for Medicare and Medicaid Services (CMS) regulations.
- Receives and responds to incoming Care Coordination inquiries from all communication venues: e.g. phone queue, TruCare, portal, claim queue, department e-mail box or Rightfax.
- Coordinates and assists in monitoring of documentation Care Management queues for Concurrent, Complex Care, and Social Work referrals, CTA processes UM requests via all communication venues, as well as administrative preparation for clinical staff.
- Conducts in-bound and out-bound calls for program requirements including, but not limited to: patient scheduling, surveys/screenings, census management and distribution of materials to appropriate clinical personnel or members.
- Performs daily preparation of Inpatient Census to include monitoring of UM expedited, standard, concurrent in-patient cases in pend and informs Care Management Manager of outstanding cases to ensure adherence to CMS regulations.
- Participates in market
- Schedules and coordinates patient transportation, follow-up physician appointments in all applicable markets, as applicable.
- Completes timely data entry of in-bound and/or out-bound call member contact information into software applications (Claims Database, TruCare, etc.).
- Provides clerical and/or administrative support to clinical staff and managers for special projects and reporting needs.
- Provides excellent customer service by serving as a resource to all internal and external customers.
- Attends required meetings and participates in adhoc committees as needed.
- Maintains knowledge of all health plan benefits, network, CMS, regulations, health plan policies.
- Maintains monthly logs for Notice of Medicare Non-Coverage (NOMNC) per delegation requirements and distributes to management.
- Performs all other duties as assigned.
- High School Diploma / GED
- 2+ years of administrative support experience.
- Advanced knowledge of Microsoft Office products, including Microsoft Excel, Microsoft Word, and Microsoft Outlook.
- Medical terminology knowledge.
- Must be 18 years of age OR older
- Ability to work full-time, Monday - Friday between 8:00am - 5:00pm including the flexibility to work occasional overtime given the business need
- 2+ years of experience in a physician's clinic or hospital.
- 3+ years of experience working in a medical care setting as a receptionist or medical assistant.
- Certified Medical Assistant training or certification.
- Bilingual language proficiency (English/Spanish).
- Reside within commutable distance of Mc
- 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
- Must possess and demonstrate excellent organizational skills, customer service skills, to include verbal and written communication.
- Must maintain and demonstrate a high degree of professionalism.
- Must maintain strict confidentiality at all times.
- Must adhere to all department/ organizational policies and procedures.
- Must be able to work independently, with some supervision and direction from manager.
-
Clinical Administrative Coordinator
1 week ago
UnitedHealth Group McAllen, United StatesIf you are in McAllen, Harlingen or Laredo, TX, you will have the flexibility to work from home and the office in this hybrid role* as you take on some tough challenges. · WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of he ...
-
Clinical Administrative Coordinator
1 week ago
UnitedHealth Group McAllen, United StatesIf you are in McAllen, Harlingen or Laredo, TX, you will have the flexibility to work from home and the office in this hybrid role* as you take on some tough challenges. · WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of he ...
-
Dispatcher (male/female/diverse)
2 weeks ago
Orion Innovations McAllen, TX, United States Freelance"Join the Logwin team We are looking for a Dispatcher (m/f/d) at our location in Aschaffenburg-Nilkheim. · Do you want to make a difference? Help shape the future at a leading logistics service provider - while being personally valued and supported? · With 4,100 employees at over ...
-
Medical Assistant
1 week ago
Akeso Occupational Health Mission Valley, United States: · **Job Summary** · Perform selected nursing and administrative/clerical duties that assist in the delivery of primary health care and patient care management under the direction of a physician. These duties are delegated in relation to the individual's degree of training, in a ...
-
Back Office Employee
2 weeks ago
Velocity Ventures Palmhurst, TX, United States FreelancePalmhurst, TX's ARWA Personaldienstleistungen GmbH offers a future-oriented employment opportunity within the framework of temporary employment with the option of permanent employment. Our company has been recognized and certified by various organizations and institutions, which ...
-
Senior Assistant Procurement
2 weeks ago
Neptune Enterprises Palmhurst, TX, United States FreelanceAre you seeking a dynamic job and do you excel in organization and coordination? Are you a proactive and independent worker? Do you have a knack for numbers and enjoy working in a team? Then join us as a Senior Assistant in Procurement in Palmhurst, TX. In this role, you will pro ...
-
Sales Support
1 week ago
SilverTech Valley Grande, United StatesSALES SUPPORT (M/F/D) - FOCUS ON AFTERSALES Philippsburg | Karlsruhe Area APPLY International Projects Company Pension Plan Positive Work Environment Short Decision-Making Paths Career Development Our client, Gawronski GmbH, has been providing innovative solutions for the logisti ...
-
Portfolio Management Clerk
1 week ago
SilverTech Edinburg, United StatesTo strengthen our team, we are currently looking for a Portfolio Management Clerk (m/f/d) in Edinburg. · Your tasks: · You maintain energy wholesale contracts with upstream suppliers in close cooperation with the legal, finance, controlling, compliance, and portfolio managemen ...
-
research services coordinator
1 week ago
University of Texas Rio Grand Valley McAllen, United StatesPlans, coordinates and processes grant applications from conceptual to submission stage while working with faculty and staff throughout all phases based on standards set in place by the University. Supports faculty, staff, and administration in devel Research, Coordinator, Facult ...
-
Research services Coordinator
1 week ago
The University of Texas Rio Grande Valley Mcallen, United StatesPlans, coordinates and processes grant applications from conceptual to submission stage while working with faculty and staff throughout all phases based on standards set in place by the University. Supports faculty, staff, and administration in developing proposals, identifying p ...
-
Commercial Clerk
2 weeks ago
Oceanic Ventures Abram, TX, United States Freelance**We are looking for: Office Clerks (m/f/d) Full-time** · **What to expect:** · - Processing of documents · - Reviewing of documents · - General administrative tasks · - Obtaining quotes from suppliers and creating quotes for customers · - Order processing and coordination with o ...
-
Executive Assistant
1 week ago
LOWER RIO GRANDE VALLEY - WORKFORCE DEVELOPMENT BOARD McAllen, United StatesJob Description · POSITION PURPOSE: · Executive Assistant performs professional assistance work for the Chief Executive Officer (CEO) of Workforce Solutions. Serves as Workforce Solutions EO Officer. Acts independently and serves as Liaison to the Board of Directors, Executive, M ...
-
research services coordinator
1 week ago
University of Texas Rio Grande Valley McAllen, United StatesPosition Information · Posting NumberSRGV7511 · Working TitleRESEARCH SERVICES COORDINATOR · Number of Vacancies1 · LocationMcAllen, Texas · DepartmentGrants and Contracts · FTE1.0 · FLSAExempt · Scope of Job · Plans, coordinates and processes grant applications from conceptual t ...
-
Telecom Billing Coordinator
1 week ago
Entravision Communications Corporation Mcallen, United StatesTelecom Billing Coordinator · McALLEN, TX | Full Time · Summary · Responsible for daily processes and activities for Telecom lines and circuits. This includes, but not limited to, coordination of installs and de-installs of telecom lines/circuits, data entry, invoice processing, ...
-
Authorization Coordinator
2 days ago
Driscoll Health McAllen, United StatesWhere compassion meets innovation and technology and our employees are family. · Thank you for your interest in joining our team Please review the job information below. · GENERAL PURPOSE OF JOB: · Using the EPIC EMR system, individual will be responsible for working with surgica ...
-
Service Coord
1 week ago
Driscoll Children's Hospital McAllen, United StatesWhere compassion meets innovation and technology and our employees are family. · Thank you for your interest in joining our team Please review the job information below. · General Purpose of Job: · The service coordination program supports maximizing the member's health, wellbe ...
-
House Supervisor RN Nights
6 days ago
Kindred Healthcare Mcallen, United StatesHouse Supervisor RN Nights · $20,000 Sign-on Bonus · $36-$53 per hour · About Us · Cornerstone Healthcare Group, based in Dallas, Texas, was founded in 1990 and provides excellent healthcare services to our patients, residents and their families. · Our employees make a difference ...
-
Front Office Receptionist
1 week ago
Alpine Physician Partners McAllen, United StatesWe're committed to bringing passion and customer focus to the business. · Job Description: · We are seeking a Medical Receptionist to join the ASAS Health team This position coordinates the daily administration of doctors, staff, visitors, and patients. The position must exemplif ...
-
UTRGV Intern
1 week ago
McAllen Independent School District McAllen, United StatesPRIMARY PURPOSE: · To enhance the knowledge and skills of district staff as they implement a student-learning framework that will focus on rigorous instruction, emotional intelligence and competitive job skills for students; provide services to students, parents and school person ...
-
House Supervisor RN Nights
3 days ago
Kindred Healthcare McAllen, TX, United States$20,000 Sign-on Bonus · $36-$53 per hour · About Us · Cornerstone Healthcare Group, based in Dallas, Texas, was founded in 1990 and provides excellent healthcare services to our patients, residents and their families. · Our employees make a difference, join us so you can too We p ...
clinical administrative coordinator - McAllen, TX , USA, United States - UnitedHealth Group Inc.
Description
If you are in McAllen, Harlingen or Laredo, TX, you will have the flexibility to work from home and the office in this hybrid role* as you take on some tough challenges.
WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors.
Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them.
We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.This position is full-time (40 hours/week)
Monday - Friday.
Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 5:00pm.
It may be necessary, given the business need, to work occasional overtime.Our office is located at Mc
Allen Market Office: 3300 N. McColl Rd.
McAllen, Texas 78501, Harlingen Market Office: 3809 West Business 83 Harlingen, Texas 78552, Laredo market office: 2324 Jacaman Rd, Laredo, TX Employees will be required to work some days onsite and some days from home.
Primary Responsibilities:
Patient Care Committees:
prepares agenda, documents minutes and distributes to appropriate venue
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:
Preferred Qualifications:
Telecommuting Requirements:
McAllen, Texas 78501 or Harlingen Market Office: 3809 West Business 83 Harlingen, Texas Or Laredo market office: 2324 Jacaman Rd, Laredo, TX 78041
Soft Skills:
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone.
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.#RPO #YELLOW