Note: The job is a remote job and is open to candidates in USA. UnitedHealth Group is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The Associate Clinical Administrative Coordinator role involves managing patient authorizations and referrals, ensuring proper communication between care managers, and maintaining high standards of customer service. This position requires flexibility in scheduling and offers opportunities for professional development.
Responsibilities
- Consistently exhibits behavior and communication skills that demonstrate Optum's commitment to superior customer service, including quality, care and concern with each and every internal and external customer
- Ensures proper input of inpatient and outpatient authorizations for acute care and skilled nursing facilities
- Informs care managers of admission, eligibility and benefits issues
- Enters, updates and close acute, observation, day surgery and SNF admission referrals within designated timeframes
- Prints, sends mails or faxes or verbally provides authorizations / referrals to providers and facilities
- Monitors fax queues for new admission notifications
- Consistently and accurately completes data entry and documentation
- Processes referrals for DME and coordinates home health services according to established policies, procedures, guidelines and timeframes
- Redirects referrals to utilization management or medical director
- Prioritizes and independently handles incoming referrals without supervision
- Directs providers and patients to contracted provider networks and facilities and updates patient information as needed
- Provides length of stay for exhaustion of SNF benefits
- Arranges post discharge appointments
- Facilitates exchange of information between all levels of care managers to ensure continuity of care
- Performs high-level critical thinking for re-directing phone calls, referrals and other issues that may arise
- Assists with answering telephones and maintaining files, logs or other reports
- Acts as a resource for team members
- Expected to participate in flexible weekday scheduling and weekend/ holiday coverage rotation per business needs
- Seeks and identifies opportunities for process improvement
- Meets or exceeds productivity targets
- Uses, protects, and discloses Optum patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
- Performs additional duties as assigned
Skills
- High School Diploma / GED OR equivalent work experience
- Must be 18 years of age OR older
- 1+ years of experience in a healthcare setting (doctor's office, medical Insurance provider or acute care setting)
- Experience with computers and Windows PC applications, which includes the ability to learn new and complex computer system application
- Knowledge of medical terminology
- Ability to work with multiple computer platforms simultaneously
- Ability to work full time. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 3:00 pm - 11:30 pm PST. This is a rotating evenings position to include holidays and alternating weekends. It may be necessary, given the business need, to work occasional overtime
- Knowledge of CPT and ICD-10 coding
- Basic understanding of managed care principles
Benefits
- A comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase
- 401k contribution (all benefits are subject to eligibility requirements)
- 4 weeks of paid training
- Training will be conducted virtually from your home.
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