Clinical Administrative Coordinator
About The Position
The Clinical Administrative Coordinator reviews and researches claims to determine whether they meet criteria for review and whether they can be allowed or need further clinical review. The role sets up cases, documents required information, sends cases to a nurse for clinical review, and completes templates with appropriate information and rationale. The position is full time, 40 hours per week, Monday through Friday, and is nationally remote within the United States. Employees must be flexible to work any 8-hour shift during normal business hours of 7:00 a.m. to 5:00 p.m. local time, and occasional overtime may be required. On-the-job training is provided, with training hours aligned to the employee’s schedule. The coordinator is expected to meet productivity, schedule-adherence, and quality standards while maintaining good attendance. The role involves prioritizing and multitasking, working with a team to solve complex problems, and performing other duties assigned by a manager or director. Remote employees must secure sensitive company documents, maintain a dedicated work area that provides information privacy, and have access to an approved high-speed internet connection. Employees must comply with UnitedHealth Group’s Telecommuter Policy.
Requirements
- High school diploma or GED, or equivalent work experience.
- Must be at least 18 years old.
- At least 1 year of professional experience in an office, customer service, or healthcare environment.
- Familiarity and fluency with computers and Windows PC applications, including the ability to learn new and complex computer system applications.
- Ability to remain focused and productive each day even when tasks are repetitive.
- Flexibility to work outside standard operating hours due to changing business needs.
- Ability to work full time, 40 hours per week, Monday through Friday, with flexibility to work any 8-hour shift during business hours of 7:00 a.m. to 5:00 p.m. local time and occasional overtime as needed.
- Ability to secure sensitive company documents, if applicable.
- A dedicated work area separated from other living areas that provides information privacy.
- Must live in a location that can receive UnitedHealth Group-approved high-speed internet or have an existing high-speed internet service.
Nice To Haves
- At least 1 year of experience with COSMOS, FACETS, or MACES.
- Clerical or administrative support background.
- Knowledge of ICD-10 and CPT codes.
- Familiarity with medical terminology.
- Experience working with claims platforms and/or authorization systems.
- Experience with medical claims processing or research.
Responsibilities
- Meet established productivity, schedule-adherence, and quality standards while maintaining good attendance.
- Review and research claims to determine whether they meet criteria for review.
- Review and research claims to determine whether they can be allowed or require further clinical review.
- Set up cases, document required information, and send cases to a nurse for clinical review.
- Complete templates with appropriate information and rationale.
- Prioritize and multitask.
- Work with the team to solve complex problems.
- Perform other duties as assigned by a manager or director.
Benefits
- Comprehensive benefits package, subject to eligibility requirements.
- Incentive and recognition programs.
- Equity stock purchase.
- 401(k) contribution, subject to eligibility requirements.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
