Clinical Administrative Coordinator – Remote
The Clinical Administrative Coordinator is responsible for the management of the census data for accurate bed day reporting. Inpatient, skilled nursing and acute rehab cases are created in the appropriate UM applications and routed to the CDU for coverage determination, eligibility verification, and routing to the assigned facility nurse as per the Priority Review (PR) and Secondary Level of Care (SLOC) criteria. CDU is responsible for capturing the most accurate census data as possible, timely discharge date entry, managing future scheduled admissions, and referrals to the applicable case management and disease management programs, while meeting the turnaround time goals to support timely clinical review.
This position is full-time (40 hours/week) Monday – Friday. Employees are required to work our normal business hours of 8:00 AM – 6:00 PM. It may be necessary, given the business need, to work occasional overtime or weekends.
We offer 2 – 4 weeks of training. Training will be conducted virtually from your home.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
- Manage notifications and case validation using standard process documents
- Route Priority Review inpatient cases from Intake to ICM and Generic work queue within required timeframe
- Focus on data integrity and accuracy for multiple downstream dependencies
- Foster collaborative working relationships with facilities, vendors, medical groups, internal clinical and non-clinical staff
- Orient new and existing facilities to the notification requirements / process
- Adhere to a work schedule based on business needs including weekend and holiday rotations
- Make timely case corrections based on the Health Care Economics Exception Reports
- Meets expected quality and productivity standards
- Be able to review benefit documents and quote INN and OON benefits
- Knowledge to create referrals in HSR
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.
- High School Diploma / GED (or higher)
- Health Care or Health Plan experience
- Previous experience working with Microsoft Office including Microsoft Outlook (ability to create, edit, save, and send emails and calendars), Microsoft Word (ability to create, edit, save, and send documents), and Microsoft Excel (ability to create, edit, save, and send spreadsheets)
- Ability to perform ICD-10, CPT, and HCPC coding
- Previous experience working with HSR (IQUE)
- Understanding of basic medical terminology
- Ability to work any 8-hour shift between the hours of 8:00 AM – 6:00 PM from Monday – Friday including the flexibility to work occasional overtime, rotating weekends, and holidays based on business need
- Associate's Degree (or higher)
- Previous CDU experience
- Reside within 50 miles of any UHC office
- Required to have a dedicated work area established that is separated from other living areas and provides information privacy
- Ability to keep all company sensitive documents secure (if applicable)
- Must have a quiet designated work space and access to install secure high-speed internet (minimum speed 1.5 download mps and 1 upload mps) via cable / DSL in home (NOTE: wireless/cell phone provider, satellite, microwave, etc… does NOT meet this requirement)
- Ability to work independently or with teams using process documents
- Comfort level to make out bound calls to facilities and provider offices
UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.
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