Evening Shift - Referral Specialist- TRICARE- (5:00pm - 1:30am) - Colorado Springs, CO at Colorado Springs

Description:

Position Description:

When you are in the business of health care, youre in the business of people. At United Health Care Military and Veterans we want every customer experience to be distinctly personal. The challenge is complex. When providers and beneficiaries call us for help, their focus is on getting the best care possible. We help them understand the benefits and their options. For the beneficiaries this part of their lives matters a lot to them and it matters just as much to us. Our Referral Management teams have a serious responsibility to make every contact informative, productive, positive, and memorable for what it says about how much we care.Primary Responsibilities:

Individuals in this position will be responsible for the daily processing of TRICARE referrals for TRICARE beneficiaries and coordination with the MTF, Military Treatment Facilities.
The special optimization of the MTF through routing referrals to them to provide services for the TRICARE beneficiaries is crucial to the success of the West Region and the beneficiaries healthcare
Make outbound calls as needed to providers to gather required information for referrals
Resolve customer service inquiries which could include:

Enter notifications, Providers status of an existing notification and determining if notification is required.
Complete notification wizard along with ICD-9 and CPT coding
Constantly meet established productivity, schedule adherence, and quality standards while maintaining good attendance.
Assist with faxes and emails, emails and letters to the beneficiaries, providers and the MTFs

Qualifications:

Requirements:

HS Diploma/GED
Ability to obtain favorable adjudication following submission of Department of Defense form SF86NAC form SF86.
US Citizenship
Familiar with medical terminology
6+ months experience in a healthcare administrative role
2+ years in an office setting using telephone and computer as primary instruments to perform job duties
6+ months medical coding experience
Assets:

Bachelors Degree preferred
Experience working in a call center with high volume
Medical front office experience preferred
Experience with Medicare and or Medicaid
Healthcare or other insurance benefits experience is preferred as well
TRICARE experience preferred
As a requirement of UnitedHealth Groups contract with the Department of Defense, this position requires U.S. citizenship and proof of favorable adjudication following submission of Department of Defense form SF86 http://www.opm.gov/forms/pdf_fill/sf86.pdf, (the National Agency Check or NAC?). Successful completion of the NAC process is a requirement for continued employment in this role. NAC processing will be initiated by our TRICARE Security Officer post-offer, and can take 3-6 months for a final decision communication from the Department of Defense. Candidates will be allowed to begin employment with UnitedHealth Group in this role based on an interim clearance, and final results will be communicated as they are received. Failure to obtain final NAC approval will result in termination from this role.UnitedHealthcare Military & Veterans is part of the family of companies that make UnitedHealth Group one of the leaders across the US health care system.We serve those who serve our nation, providing quality health care services to millions of military beneficiaries across the (list region post award).Our commitment to helping people live healthier lives, and to continue the honor, satisfaction, and quality of the TRICARE military health benefit program is greater than ever. Our efforts complement the Military Health System to demonstrate the best blend of public and private health care solutions.Its not just business as usual. It is one of our proudest endeavors.If youre ready to help make health care work better for those who serve our nation. If you are smart, creative, and committed. If you want to make a difference. Consider being part of the elite team at UnitedHealth care Military & Veterans.This is an opportunity to share in something special; a chance for all of us to serve, to excel, and to know that weve made a difference for those families who have made our nation stronger.Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/VAll qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin.UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
Country: USA, State: Colorado, City: Colorado Springs, Company: UnitedHealth Group.