UCare

AG Intake Coordiantor

Employer
UCare
Location
Minneapolis, Minnesota
Posted
Sep 09, 2020
Closes
Sep 19, 2020
Ref
2092
Category
Healthcare
Employment Status
Full Time
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.

Rewards

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.

www.ucare.org/careers/

EOE/AA

ABOUT UCARE At 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 UCARE Working 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.

APPEALS AND GRIEVANCES INTAKE COORDINATOR

Position Description This position is responsible for operational and administrative tasks related to the intake of appeals and grievances (AG) for State Programs, Commercial and Medicare products. Responsibilities include coordinating the identification, documentation, appeals and grievances appropriately and timely according to regulatory timelines.

• Analyze, answer, resolve, and document incoming telephone calls from members, providers, internal departments, and external agencies, according to State, Federal or Commercial regulatory timelines.

• Consistently monitor and research incoming appeals and grievances requests and inquiries; including potential expedites, from mail, voicemail, fax, Macess AG queue, portal and email according to State, Federal or Commercial regulatory timelines.

• Contact members, providers and delegates as necessary to obtain information required to initiate appeals and grievances and educate on the process.

• Provide updates on appeal and grievance status to members, providers and UCare staff or delegates as requested.

• Ensure all appeals and grievances are categorized and assigned to coordinators appropriately and entered in the system and maintain accurate data according to State, Federal or Commercial regulatory guidelines.

• Communicate concepts clearly and professionally and adapts communication style to audience and situation. Demonstrate expert conflict resolution skills by resolving or de-escalating member/provider related issues in identified areas to both internal and external customers.

• Assist coordinators with acknowledgement letters and other administrative duties as required.

• Prioritize case set up to ensure expedited cases are entered and assigned as soon as possible.

• Assist with audit preparation and review and update spreadsheet data for special projects as requested.

• Other projects and duties as assigned.

Education Bachelor's degree in health related field; demonstrated experience may be considered in lieu of degree.

Required Experience Experience with Medicare, Medicaid & Commercial benefit programs. Demonstrated experience in completing clear and meaningful written and verbal communication.

Preferred Experience Experience answering benefit and claim questions. Claims adjudication process experience. Experience in pharmacy utilization review. Amisys experience and proficiency in Microsoft Office program; Word, Excel and Access.

THE UCARE DIFFERENCE UCare is proud to be a recognized Star Tribune Top Workplace for the 10th 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.

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