Clinical Administrative Coordinator

4 days ago

Elmendorf, Texas, United States Optum Full time
Optum Job Opportunity

At Optum, we strive to deliver care and technology to help millions of people live healthier lives. Our team is dedicated to connecting people with the care, pharmacy benefits, data, and resources they need to feel their best.

Job Summary

We are seeking a skilled Clinical Administrative Coordinator to join our team. In this role, you will be responsible for processing Utilization Management (UM) Inventory and providing clerical support to our clinical staff. You will work closely with our Medical Directors, UM Nurses, hospitals, physicians, and other departments to ensure seamless coordination of UM processes.

Key Responsibilities
  • Research and resolve UM inventory discrepancies to meet productivity and quality standards.
  • Coordinate initial screening for UM claim reviews through claim queue.
  • Prepare administrative files for Medical Directors, UM Nurses, and Case Managers.
  • Contacts provider offices to obtain clinical information for medical review by a clinician.
  • Maintain knowledge of various health plan partner benefits, networks, CMS regulations, and health plan partner policies.
  • Utilize experience and judgment to plan, accomplish goals, and effectively resolve each assigned task.
Requirements
  • High School Diploma/GED or equivalent experience.
  • Must be 18 years of age or older.
  • 1+ years of experience in a hospital, physician's office, or medical clinic setting.
  • 6+ months of experience with using Medical Terminology.
  • 6+ months of experience with working in an environment that is based on meeting metrics and daily goals.
  • Proficiency with Microsoft Office applications (i.e., Microsoft Excel, Microsoft Access).
  • Ability to work onsite at 19500 W Interstate, San Antonio, TX.
  • Ability to work any 10-hour shift for 4 days between the hours of 9:00 AM - 8:00 PM or 7:00 AM - 6:00 PM from Wednesday - Saturday or Sunday - Wednesday, including the flexibility to work occasional weekends and holidays based on business need.
Preferred Qualifications
  • 2+ years of experience in a hospital, physician's office, or medical clinic setting.
  • Experience in working with healthcare insurance.
  • Clerical or administrative support background or experience with working in a call center environment.
Soft Skills
  • Exceptional ability to organize, prioritize, and communicate effectively.
  • Ability to navigate multiple systems.
  • Ability to work in a fast-paced environment.

At Optum, we believe that diversity creates a healthier atmosphere. We are 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.

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