Pre-Service Coverage Coordinators - Full-Time!

Pre-Service Coverage Coordinators - Full Time! VIRTUAL JOB FAIRSee what we’re all about,visit our Virtual Job Fair at:[new-line]www.UHGjobsonline.com  JOIN UNITEDHEALTH GROUP, A LEADING FORTUNE 100 COMPANY, IN PLANO!! UnitedHealthcare, a UnitedHealth Group company, provides network-based health and well-being benefits and services for employers and consumers nationwide. We use our strength, diversity and innovation to improve the lives of the more than 18 million people who receive our unique products and services. And our endless pursuit for excellence in everything we do extends to your career as well. Join us today for an inspired and purposeful mix of professional growth opportunities and personal rewards. Primary Responsibilities:·The Pre-service Coverage Determination Coordinator is responsible for receiving Care Coordination notification cases for non-clinical assessment/intervention and providing appropriate triage. ·Processes out of network requests for consideration of in network level of benefits for physician specialty referrals for appropriate products·Processes notification requirements for outpatient procedures, home health, DME, transition of care, and network gap issues·Determines benefit coverage issues based on employer group contracts·Sets up/documents/triages cases for (CCR) Clinical Coverage Review·Ensures all potential member needs are identified and forwarded to the appropriate Care Coordinator for risk validation when applicable·Process Salsa letters within DOL time frames·Verifies appropriate ICD-9 and CPT coding usage ·Communicates to provider and member benefit determinations within DOL time frames·Other duties as assigned by manager and/or director  Qualifications:·Capable of working in a complex, fast paced, dynamic environment that involves multiple customer types, products and evolving systems.·Ability to work autonomously - must be a self-starter·Ability to work in a rapidly changing environment - adaptable, flexible ICD-9 and CPT coding required· Computer proficiency required·Customer service experience preferable·Working knowledge of benefit design and interpretation·Excellent oral and written communication skills·Excellent time management and interpersonal skills·A strong background in the healthcare industry Visit us at [new-line]www.UHGjobsonline.com .  We are currently recruiting for Full-Time Pre Service Coverage Coordinators to work in our state-of-the-art Service Center. If an opportunity to work for one of America’s premier companies is exciting to you, then log on NOW to experience our interactive, multimedia virtual job fair.  Find out today all you need to know about our company, our jobs, our culture, compensation and benefits! We Offer:  Competitive pay.  Paid training. Comprehensive medical and dental benefits. 401(k) savings plan with matching funds. Employee stock purchase plan. Generous vacation and holiday schedule. Dependent care spending account. Much more!  GO ONLINE TO ATTEND THE VIRTUAL JOB FAIR AT www.UHGjobsonline.com  If you’re unable to log on, we’d still like to hear from you. You may email your resume to: UHGPlano@uhgrecruitmentservices.com  Diversity creates a healthier atmosphere: An equal opportunity employer