Clinical Administrative 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. Under the supervision of the Referral Management Center Supervisor, the Clinical Administrative Coordinator position is responsible for the daily coordination of referral processes and other duties as assigned. This position is full-time, Monday - Friday. Employees are required to have flexibility to work our normal business hours of 8:00am - 5:00pm. It may be necessary, given the business need, to work at the two other locations in Albuquerque. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Requirements
- High School Diploma/GED (or higher)
- 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
- 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 thoroughly 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
Benefits
- In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives.
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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
