Healthcare Associates
Job ID: 102903 Job Views: 355 Posted: 2012-03-08 Location: Philippines Quezon City, Metro Manila
Job Description
The role of the Healthcare Associate is to be responsible for initial triage of members, administrative intake of members or managing the admission/discharge information post-notification. This position coordinates, supervises and is accountable for the daily activities of business support, technical or production team. Responsibilities’ include but are not limited to managing incoming calls, managing requests for services from providers/members, providing information on available network services and transferring members as appropriate to clinical staff. This position is responsible for managing the referrals process, processes incoming and outgoing referrals, and prior authorizations. This function includes intake, notification and census roles.
Responsibilities:
Demonstrated ability to perform duties in all areas of Intake including specialty teams.
Function as a preceptor to new hire agents.
Receive and coordinate all incoming calls for appropriate service. Includes those calls that need pre-certification.
Verify eligibility as appropriate.
Educate providers and plan participants on benefits of provider network.
Effectively handle a variety of customer or provider requests/needs. Follow through to assure problem resolution.
Complete intake screening which includes obtaining and documenting in the medical management system all require patient, provider, demographic and treatment information.
Determine the necessity for pre-certification of services requested based upon policy and benefit protocols, correct service center etc.
Review past medical/claim history and document updates in the medical management system as appropriate.
If appropriate, refer case to a Case or Care Coordinator for assessment based on patient information and the care/services requested.
Act as the liaison between the Case and Care Coordinator for assessment based on patient information and the care/services requested.
Process faxes, emails, IRU.
Perform other duties as assigned.
Minimum Requirements:
Bachelor's Degree in a medical or healthcare field is HIGHLY PREFERRED.
At least 6 months - 1 year health care or health plan experience with the ability to perform ICD-9, CPT and HCPC coding is an ADVANTAGE.
At least 6 months – 1 year experience working in a BPO/Call Center.
Good communication skills, verbal and written.
Experience in using MS Windows based PC skills (Word, Excel, Outlook)
Understanding of basic medical terminology.
Open to work on a night shift schedule.
Please copy + paste the link below on your web browser for more information and click the "Click here to Apply" button.
http://careers.unitedhealthgroup.com/Data/Jobs/Medical%20and%20Clinical%20Operations/372941%20Intake%20Notification%20Coordinator%20Manila%20Philippines.aspx
http://careers.unitedhealthgroup.com
Location: 24th Floor, IBM Plaza, 8 Eastwood Ave., Eastwood City Cyberpark, E. Rodriguez Jr. Ave., Libis, Quezon City
How to apply: Send CVs to Kathleen_Resulta@uhgrecruitmentservices.com, walk-in, send sms or call 0917-5790508.
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Company Information
UnitedHealth Group
24th Floor, IBM Plaza, 8 Eastwood Ave., Eastwood City Cyberpark, E. Rodriguez Jr. Ave., Libis, Quezon City Quezon City Metro Manila Philippines
Contact Name: Kathleen Resulta
Phone: 0917-5790508
Web: http://careers.unitedhealthgroup.com
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