Patient Care Coordinator

UnitedHealth Group•Albuquerque, NM

10d•$18 - $32•Onsite

About The Position

The Patient Care Coordinator supports the Radiology Department by coordinating referral processes and performing related administrative duties under the supervision of the Referral Management Center Supervisor. The role is based at 5150 Journal Center Blvd. NE, Albuquerque, New Mexico, with training and coverage at other Albuquerque and/or Rio Rancho clinics as business needs require. The schedule is Monday through Friday, 8:00 a.m. to 5:00 p.m. Mountain Standard Time; the posting also states that the position requires flexibility to include evening hours. This is a high-volume, customer-service role involving frequent phone interactions with members and providers. The coordinator manages incoming and outgoing referrals and prior authorizations, handles service requests and inquiries, maintains department records, and performs radiology exam and CD processing tasks according to established protocols and timelines. The role also supports clinical staff with documents and case setup for Clinical Coverage Review.

Requirements

High school diploma or GED.
At least 1 year of customer service experience in a healthcare setting.
Intermediate proficiency in Microsoft Office applications, including Excel, Word, and Outlook.
Ability to work efficiently, productively, and thoroughly in a high-volume customer-service environment and handle phone interactions with members.
Ability to work a flexible schedule that includes evening hours.

Nice To Haves

Experience in the healthcare industry and with health insurance.
Experience in a hospital, physician's office, or medical clinic setting.
Knowledge of ICD-9 and CPT codes.
Previous radiology experience.
Clerical or administrative support background.
Previous experience with 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 internal and external referral processes and perform daily referral reconciliation, gathering required information and documents and processing referrals within established timelines.
Manage administrative intake of members.
Maintain department records as requested by the supervisor, department director, and/or regulatory agencies.
Receive exam CD checkout requests, process them, and prepare requests according to protocol.
Receive and process outside-facility incoming exams in the RIS and download those exams into PACS.
Prepare and process outside-facility exams for return to the facility or patient, and process returned exams.
Maintain CD files and purge outdated exams.
Request pertinent prior exams for all modalities according to protocol.
Work with hospitals, clinics, facilities, and the clinical team to manage member and provider requests for services.
Process incoming and outgoing referrals and prior authorizations, including intake, notification, and census roles.
Assist clinical staff by setting up documents and triaging cases for Clinical Coverage Review.
Resolve and respond to inquiries from members and/or providers.
Perform other related duties as assigned.

Benefits

Paid Time Off accrued starting with the first pay period, plus 8 paid holidays.
Medical plan options and participation in a Health Spending Account or Health Savings Account.
Dental, vision, life and AD&D insurance, and short-term and long-term disability coverage.
401(k) Savings Plan.
Employee Stock Purchase Plan.
Education reimbursement.
Employee discounts.
Employee Assistance Program.
Employee Referral Bonus Program.
Voluntary benefits, including pet insurance, legal insurance, and long-term care insurance.
Incentive and recognition programs.
Equity stock purchase and 401(k) contribution, subject to eligibility requirements.