Clinical Administrative Coordinator

This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

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.

Optum's Pacific West region is redefining health care with a focus on health equity, affordability, quality, and convenience. From California, to Oregon and Washington, we are focused on helping more than 2.5 million patients live healthier lives and helping the health system work better for everyone. At Optum Pacific West, we care. We care for our team members, our patients, and our communities. Join our culture of caring and make a positive and lasting impact on health care for millions.

Responsible for providing administrative and clerical support within area of responsibility that may include telephone support, filing, typing, coordinating schedules, distributing correspondence, materials management, data entry, simple data analyses, and rudimentary reporting. All within established legal guidelines and maintaining confidentiality at all times.

This position is full-time, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 5:00pm PST. It may be necessary, given the business need, to work occasional overtime and weekends (rotate weekends every other weekend). 

We offer 4 weeks of paid training. The hours during training will be 8:00am - 5:00pm, Monday - Friday.

Primary Responsibilities:

• Consistently exhibits behavior and communication skills that demonstrate our company's commitment to superior customer service, including quality, care and concern with each and every internal and external customer
• Performs effective prospective and concurrent review of requested services according to established guidelines and timeframes
• Documents members' service benefits by contacting the appropriate health plans as needed
• Directs providers/members to contracted provider network and facilities
• Processes appropriate authorizations for HMO/PPO clients as specified in the Optum procedures
• Enters, updates and closes referrals daily while assuring that appropriate internal/external referral providers are utilized, members are eligible and have benefits coverage, correct CPT/ICD-9 codes have been entered, accurate records of all dates and other required fields are entered, supporting clinical data for the referrals is entered, and all urgent referrals are processed within the designated timeframe
• Processes referrals for durable medical equipment and coordinates home health services according to established policies, procedures and guidelines
• Coordinates, identifies and routes referrals that require review to licensed Care Management staff who arranges outside physician medical review as appropriate
• Acts as a resource to other coordinators, staff and providers by resolving issues and responding to requests in a timely and effective manner
• Works with Patient Services regarding member concerns
• Processes referrals for inter-facility transfers using pre-established guidelines
• Processes after-hours emergency/urgent care logs/lists as needed
• Collects and prepares medical records for review when appropriate or as requested
• Assists with answering telephones and maintaining files, logs or other reports
• Uses, protects, and discloses Optum patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
• Assist with Insurance and benefits verification 
• Attends and participates in Interdisciplinary rounds

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 experience in front office, back office, coordinator, insurance OR medical group
• Ability to work an 8-hour shift during our normal business hours of 8:00am - 5:00pm PST, including the flexibility to work occasional overtime and weekends (rotate weekends every other weekend), based on the business need

Preferred Qualifications:

• 2+ years of office experience in healthcare industry at the corporate level
• 1+ years of experience in insurance eligibility
• Intermediate level of experience with Microsoft Suite

Telecommuting Requirements:

• Ability to keep all company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. 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. The hourly pay for this role will range from $17.98 - $32.12 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

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