Clinical Administrator Coordinator
About The Position
Explore opportunities with Optum, in strategic partnership with ProHealth Care. ProHealth Care is proud to be a leader in health care services, serving Waukesha County and the surrounding areas for more than a century. Explore opportunities across the full spectrum of care as you help us improve the well-being of the community with your skills, compassion and innovation. Be part of a collaborative environment that strives for excellence, nurtures respect and ensures high-quality care delivery to our patients. Join us in making an impact as an Optum Team Member supporting Pro Health Care and discover the meaning behind Caring. Connecting. Growing together. Primary Responsibilities: Working with a team of nurses to obtain CMS required forms 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 Assist the clinical staff in denials management and utilization management: faxing, scanning and portal entries Providing in-person support to patients and families by addressing forms, letters and transportation matters This is a fast-paced, high volume, customer service environment. You must be efficient, productive, and thorough when assisting patients and families in person and telephonic. We are looking for team members who have flexibility with some early evening availability This role includes rotating weekend coverage every 4-6 weeks and one holiday shift annually Dress code corporate casual attire Ability to travel up to 10%25 within the hospital system You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction 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 with MS Word, Excel and Outlook
Nice To Haves
- Associates degree
- Experience working within the health care Industry
- Experience working in a hospital, physician's office or medical clinic setting
- A clerical or administrative support background
Responsibilities
- Working with a team of nurses to obtain CMS required forms
- 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
- Assist the clinical staff in denials management and utilization management: faxing, scanning and portal entries
- Providing in-person support to patients and families by addressing forms, letters and transportation matters
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
