Provider Triage Coordinator
Health Care that Starts with You!
Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota's leading health plans. We provide more than 225,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs. UCare is growing in size, membership, products, geographic coverage, and employees. We're an organization that's going places. Be part of a team that cares about you, be part of UCare.
ABOUT UCAREAt UCare, we deliver high-quality health coverage and services to help members of all ages maintain and improve their health. It's a big job that takes innovative ideas, strategic partnerships, and a commitment to doing the right thing. Above all, it takes a compassionate team that is dedicated to making a real difference in the lives of our members and our communities. WORKING AT UCAREWorking at UCare is more than just a career; it's a mission. A mission that defines us as professionals, unites us as an organization, and shapes how we interact with our members and each other. Our values of integrity, community, quality, flexibility, and respect permeate every aspect of our organization - from who we are and how we act, to what we do and how we do it. We owe our continued success to our employees who proudly embody our mission and values in everything they do. PROVIDER TRIAGE COORDINATOR Position DescriptionThis position is responsible to support UCare's efforts in delivering an excellent provider experience by effectively resolving payment and service issues in a timely manner. Use critical thinking skills and claims payment knowledge to conduct root cause analysis when driving to resolve issues. Support key provider relationships by collaborating with operations staff within key provider organizations to identify, document and resolve payment issues. Clearly document the issues, related research, tasks and decisions while regularly keeping impacted providers informed of the progress. Escalate issues, risks or barriers as necessary. Specific duties and responsibilities include: Collaborate daily with internal staff and providers to effectively resolve provider payment and/or service issues in a timely manner.Document, research and resolve provider problems, including issues that impact more than one provider and key UCare providers like care systems. Communicate, prioritize and monitor work needed from various areas within UCare to resolve provider issues.Ensure that providers impacted by an issue are routinely informed about the progress toward resolution. Participate in face-to-face meetings, as needed. Develop a comprehensive knowledge of member benefits for each product; understand, implement, and support the Evidence of Coverage, and follow organization policies as they relate to member benefits.Develop summaries, reports and other documentation regarding provider issue resolution at UCare for a variety of audiences. Share the provider experience within UCare to support efforts to improve our work with provider partners. Engage leadership regarding barriers to addressing issues in a timely manner or for any other guidance in advancing issue resolution.Identify and communicate trends in provider issues to support systemic/process improvements, provider education and corporate compliance activities, as needed.Other projects and duties as assigned. EducationBachelor's degree; demonstrated experience may be considered in lieu of a degree. Required ExperienceThree years of experience in health care billing and/or payment setting. Examples include health plan claims processing, provider assistance center, provider network management, or patient account management. Preferred ExperienceProvider services experience. Knowledge of health care claims processing and systems. Knowledge of State Public Programs, Medicare and commercial health plan products. Project management training or experience. SharePoint and Microsoft software proficiency. THE UCARE DIFFERENCEUCare is proud to be a recognized Star Tribune Top Workplace for the 9th consecutive year. As a part of our collaborative team, you'll experience the rewards that come with helping others and seeing the positive results of your hard work. We value and respect each individual's ideas and contributions, and give you the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, a myriad of volunteer activities, and a number of other rewards. If you're looking for a welcoming environment that celebrates what you have to offer, helps you build on your strengths, and gives you the opportunity to truly make a difference, we invite you to apply. As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.
Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You'll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis just minutes from major freeways and retail centers.
At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.