Clinical Administrative Coordinator

3 weeks ago


Commerce, California, United States Optum Full time

Transforming Healthcare with Optum

At Optum, we're dedicated to delivering exceptional care and improving health outcomes for millions of people worldwide. As a Clinical Administrative Coordinator, you'll play a vital role in our mission by providing administrative and clerical support within our healthcare operations.

Key Responsibilities:

  • Provide exceptional customer service to internal and external customers, consistently demonstrating our company's commitment to quality, care, and concern.
  • Perform effective prospective and concurrent review of requested services according to established guidelines and timeframes.
  • Document members' service benefits by contacting health plans as needed.
  • Direct providers/members to contracted provider networks and facilities.
  • Process authorizations for HMO/PPO clients as specified in Optum procedures.
  • Print and mail authorizations to providers, patients, HMOs, and facilities as needed.
  • Assist and monitor the processing of referrals, ensuring accurate records and timely completion.
  • Process referrals for durable medical equipment and coordinate home health services according to established policies and procedures.
  • Coordinate elective surgical requests, including notification of inpatient teams and Hospitalists as needed.
  • Act as a resource to other coordinators, staff, and providers, resolving issues and responding to requests in a timely and effective manner.
  • Work with Patient Services to address member concerns.
  • Process inter-facility transfers using pre-established guidelines.
  • Process after-hours emergency/urgent care logs/lists as needed.
  • Collect and prepare medical records for review as requested.
  • Assist with answering telephones and maintaining files, logs, or other reports.

Requirements:

  • High School Diploma/GED or equivalent experience.
  • Must be 18 years of age or older.
  • 1+ years of experience in front office, back office, coordinator, insurance, or medical group settings.
  • Ability to work our normal business hours of 8:00am - 5:00pm (rotate weekends every other weekend) with occasional overtime as needed.

Preferred Qualifications:

  • 2+ years of office experience in the healthcare industry at the corporate level.
  • 1+ years of experience in insurance eligibility.
  • Intermediate level of experience with Microsoft Suite.

Telecommuting Requirements:

  • Reside within commutable distance to Commerce, CA.
  • Ability to keep all company-sensitive documents secure.
  • Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
  • Must live in a location that can receive a UnitedHealth Group-approved high-speed internet connection or leverage an existing high-speed internet service.


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