Clinical Administrative Coordinator

UnitedHealth Group•Albuquerque, NM

8h•$18 - $32•Hybrid

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. Under the supervision of the Referral Management Center Supervisor, the Clinical Administrative Coordinator position are responsible for the daily coordination of referral processes and other duties as assigned.

Requirements

High School Diploma/GED
2+ years of customer service experience
Intermediate level of proficiency in Microsoft Office applications including Excel, Word and Outlook

Nice To Haves

Experience working within the health care Industry and with health care insurance
Experience working in a hospital, physician's office or medical clinic setting
Knowledge of ICD-9 and CPT codes
Previous experience working in radiology
A clerical or administrative support background
Previous experience working within an Electronic Health Record (EHR) system
Demonstrated ability to manage and respond effectively to high call volumes
Working knowledge of medical terminology and clinical documentation

Responsibilities

Manage the internal/ external referral process and daily referral reconciliation gathering required information and documents needed, working them accordingly in compliance with established timelines
Manage administrative intake of members
Maintains department records as requested by supervisor, department director and/or other regulatory agencies
Maintains area according to the following duties; Receives all requests for exam (CD)- check out Processes requests and prepares CD check-out requests according to protocol Receives and processes in the RIS all outside facility in-coming exams Down-load all outside facility exams in PACS Prepares and processes all outside facility exams for return to facility or patient Processes in all returned exams Maintains CD files and purges outdated exams Requests pertinent prior exams for all modalities per protocol
Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providers
Process incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles
Assist the clinical staff with setting up documents/triage cases for Clinical Coverage Review
Handle resolution/inquiries from members and/or providers
This is high volume, customer service environment. You'll need to be efficient, productive and thorough dealing with our members over the phone. You also must be able to work a flexible schedule that includes evening hours
Performs all other related duties as assigned