Clinical Administrative Coordinator – Waukesha, WI

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.

This position is full-time. Employees are required to work our normal business hours of 8:00am – 4:30pm, Monday – Friday with rotational weekend and holiday work. It may be necessary, given the business need, to work occasional overtime. Our office is located at 2 – 725 American Ave Waukesha, WI 53188.

We offer 4 weeks of on-the-job training. The hours of the training will be aligned with your schedule.

 

Primary Responsibilities:

• Review medical records and take all necessary actions to expedite benefit approval
• Adhere to company and legal standards regarding Protected Health Information (PHI), Personal Identifiable Information (PII) and Personnel Transaction Identifier (PTI)
• Maintain ongoing communication with external systems regarding the status of claims
• Provide updates and assistance to hospital personnel and other Optum staff as needed
• Maintain documentation of status of claims and client contract on Optum and/or hospital computer systems
• Able to work in a fast-paced hospital or healthcare environment
• Complete Care Management functions to maintain compliance with regulatory requirements
• Provide excellent customer service in a healthcare setting
• Completes scanning, deficiency analysis, vital statistics, and release of information functions adhering to HIPAA, State & Federal statues on release of information, and Joint Commission/CMS requirements for chart completion
• Safeguard patient’s protected health information at all times
• Must be able to go to the nursing units to complete necessary job requirements and communicate with patientsAnalyze charts for missing care management documentation and elevate missing items to clinical staff according to hospital policies and procedures
• Complete monthly Audit on hospital charts as assigned
• Answer incoming calls for Care Management department and notify the appropriate team member
• Abstract required information in the electronic medical record (Epic)
• Maintain established quality & productivity benchmarks
• Document pertaining to continuing care and patient/authorized representative requests
• Maintains and exhibits current knowledge of profession and completes required continuing education
• Maintains a safe environment complying with policies and procedures; reports and directly addresses environmental hazards and violations of patient safety policy and/or protocol when involved or observed
• May perform other duties upon request

 

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. 

Required Qualifications:

• High School Diploma / GED OR equivalent work experience
• Must be 18 years of age OR Older
• 1+ years of Healthcare Customer Service experience
• Experience with Microsoft Office products
• Ability to travel up to 10% to local healthcare facilities
• Ability to work onsite full time at 725 American Ave Waukesha, WI 53188
• Ability to work our normal business hours of 8:00am – 4:30pm, Monday – Friday with rotational weekend and holiday work. It may be necessary, given the business need, to work occasional overtime

 

Preferred Qualifications:

• Bilingual – English/Spanish
• Clerical or administrative support background
• Experience working within the health care Industry and with health care insurance
• Experience working in a hospital, physician’s office or medical clinic setting
• Experience working in a call center

 

Soft Skills:

• Strong analytical and mathematical skills to collect and interpret data to solve problems
• Strong interpersonal skills and the ability to communicate with many different levels of employees
• Ability to make sound decisions quickly in a fluid work environment
• Ability to multi-task in a fast-paced environment

 

The hourly range for this role is $16.88 to $33.22 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

 

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

 

 

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

 

UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.

 

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