Associate Patient Care Coordinator
About The Position
Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Clinical Administrative Coordinator is responsible for reviewing and processing requests for prior authorization, referrals, or denials in accordance with insurance provider guidelines. This role requires a solid understanding of healthcare insurance policies, pharmacy benefit management, and medical terminology.
Requirements
- High School Diploma/GED (or higher)
- 1+ years of customer service experience
- Intermediate level of proficiency in Microsoft Office applications including Excel, Word and Outlook
Nice To Haves
- 2+ years of experience in health care, including understanding of health plan related operations
- Experience in Managed Care
Responsibilities
- Acquire and maintain a working knowledge of health plan formulary and authorization requirements
- Utilize systems to facilitate faster turnaround time on a complete authorization
- Gather necessary information from chart review to submit prior auth request to insurance providers
- Act as a liaison between providers, pharmacy, health plans and patients to support a timely medication authorization process
- Communicate with providers, pharmacy, and patients to provide updates on the status of their prior auth request
- Document in the patient electronic health record all medication authorization work provided following standard work guidelines
- Provide and document in EPIC medication authorization denials and health plan recommendation and or alternatives when provided
- Assist with front office tasks as needed
Benefits
- a comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
5,001-10,000 employees
