Inpatient Coordinator - Remote in Signal Hill, CA

If you are located within Signal Hill, CA , you will have the flexibility to telecommute* (work from home) as you take on some tough challenges.

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.

Positions in this family include those responsible for functions in areas such as health services, clinical services and delivery of clinical care.

This position is full time. Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8am - 5pm.

It may be necessary, given the business need, to work occasional overtime. Our office is located at E WILLOW ST Signal Hill, CA.

We offer 2 weeks of paid training. The hours during training will be 8am to 5pm PST, Monday - Friday.

All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary Responsibilities :

• Receive Medical / Behavioral / Clinical Services or Benefits Requests
• Serve as primary point of contact for providers or members regarding medical / behavioral / clinical services or benefits
• Extract and review fax requests for medical or clinical services
• Receive calls requesting medical / behavioral / clinical services or benefits information (e.g., from providers or members)
• Receive electronic referral form requests for medical / behavioral / clinical services
• Utilize phone system to respond to and transfer calls to appropriate individuals
• Ask callers standard questions to understand requests, gather necessary information, and assess urgency
• Access electronic member files using policy or id number
• Determine member eligibility
• Follow protocols to task requests appropriately
• Check procedure codes against notification requirements and benefit coverage to determine next steps
• Reference automated job aid tools via the computer to identify appropriate procedures when needed
• Research Information to Respond to Medical / Behavioral / Clinical Services or Benefits Re C) Fully Proficient
• Access claims information
• Review and interpret call history documentation (e.g., case notes)
• Navigate between computer screens and platforms to research information (e.g., medical, clinical, or benefits information)
• Take calls and questions from members and / or providers regarding case status
• Determine whether authorizations are required for requested medical services
• Reference automated job aid tools via 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 requests

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
• Must be 18 years of age or older
• 1+ years health plan managed care experience
• Ability to work full time. Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8am - 5pm.

It may be necessary, given the business need, to work occasional overtime.

Preferred Qualifications :

• Knowledge of medical terminology
• CPT and ICD-10 coding experience

Telecommuting Requirements :

• Reside in E WILLOW ST Signal Hill, CA.
• 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.

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Washington, Rhode Island, OR Washington, D.C. Residents Only : The hourly range for this is $16.

54 - $32.55 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.