Job Information
UnitedHealth Group Patient Care Coordinator in Worcester, Massachusetts
$1,000 SIGN ON BONUS FOR EXTERNAL APPLICANTS
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.
Primary Responsibilities:
Respond to patient questions in person or over the phone
Greet patients and build rapport to provide a positive patient experience
Collect patient payments
Make patient follow up calls (e.g., after procedures, admissions, or ER visits) to identify/close gaps in care
Ask patients for and/or assist patients with completing required paperwork (e.g., health history, insurance documentation, etc.)
Connect patients with outside resources (e.g., community resources, social services) to promote self care
Review and support implementation of patient plan of care
Work directly with patients to identify specific needs and/or request adjustments to plan of care
Coordinate services/case management for non-episodic and non-catastrophic cases
Manage/respond constructively to challenging patient interactions (e.g., address lack of understanding, socioeconomic challenges frustrated patients, language barriers)
Explain and talk to patients or caregivers about sensitive health care decisions such as advanced directives, physician's order for life sustaining treatment, and palliative care/hospice referrals
Explain and ensure understanding of details related to patient care (e.g., , home health care transition procedures)
Explain medical benefits/coverage specifics (e.g., procedures/amounts covered, denials of coverage, appeal rights)
Utilize Computer Systems to Pull/Verify/Enter Patient Data
Access insurance plan systems to verify insurance eligibility/benefits for patients and seek additional information as necessary
Input/update patient demographic data into computer system
Update/upload patient care data (e.g., care plan data, inpatient data, patient program flags) in computer systems
Document patient interactions in appropriate systems/logs (e.g., medication changes)
Enter/process patient referral data (e.g., medical services, radiology, durable medical equipment)
Generate reports on patient data through relevant computer systems/applications
Review/analyze patient data reports (e.g., discharges, hospital admissions/readmissions, skilled nursing facilities) and follow up as necessary
Identify inconsistencies in diagnosis/procedure codes and update codes in the system
Enter patient payments, prepare deposits, and balance daily deposit log/ledger
Draft/provide written communications to patients (e.g., standard letters, welcome letters, educational materials) in compliance with company and health plan guidelines
Maintains patient/staff data and generates aggregate data report
What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:
Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
Medical Plan options along with participation in a Health Spending Account or a Health Saving account
Dental, Vision, 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, legal 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 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 (or higher)
Preferred qualifications:
Understanding of relevant health plan guidelines and benefits (e.g., Medicare, Medicaid/Medical, commercial benefit plans, Federal/local government regulations)
Understanding of Federal privacy regulations (e.g., HIPAA)
Knowledge of safety guidelines/practices (e.g., OSHA)
Knowledge of basic medical terminology and human anatomy to document patient information using standard language/medical terminology
Understanding of evidence-based practice guidelines (e.g., Millliman) to evaluate medical necessity of procedures
Understanding of managed care policies/procedures that apply to patient care
Understanding of managed care practices/contract provisions to evaluate appropriateness of services (e.g., contracted providers, financial implications, relevant regulations
*PLEASE NOTE The sign-on bonus is only available to external candidates. Candidates who are currently working for UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time or per diem basis ("Internal Candidates") are not eligible to receive a sign on bonus.*
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.
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