Note: The job is a remote job and is open to candidates in USA. Optum is a global organization that delivers care aided by technology to help people live healthier lives. The Clinical Administrative Coordinator supports patient scheduling, records and insurance data management, referrals, patient communications, provider support, and general administrative operations in a remote healthcare setting.
Responsibilities
- Respond to patient questions in person or over the phone
- Greet patients and build rapport to provide a positive patient experience
- Input/update patient demographic data into computer system
- Make patient follow up calls to identify/close gaps in care
- Ensure provider templates/procedures are built correctly to schedule appointments in appropriate time slots
- Appointment reminder calls and reschedules
- Ask patient questions to verify patient data or needs for scheduling
- Coordinate/confirm scheduling of doctor visits/services with patients
- Make calls to doctor's office on patient's behalf to schedule, check progress, and facilitate the care process
- Ask patients for and/or assist patients with completing required paperwork (e.g., health history, insurance documentation, etc.)
- Connect patients with outside resources (e.g., community resources, social services) to promote self-care
- Work directly with patients to identify specific needs and/or request adjustments to plan of care
- Manage/respond constructively to challenging patient interactions (e.g., address lack of understanding, socioeconomic challenges, frustrated patients, language barriers)
- Explain and talk to patients or caregivers about sensitive health care decisions
- Explain and ensure understanding of details related to patient care (e.g. outside referrals, medications, etc.)
- Explain medical benefits/coverage specifics (e.g., procedures/amounts covered, denials of coverage, appeal rights)
- Access insurance plan systems to verify insurance eligibility/benefits for patients and seek additional information as necessary
- Update/upload patient care data (e.g., care plan data, inpatient data, patient program data) in computer systems
- Enter/process patient referral data (e.g., medical services, radiology, durable medical equipment)
- Verify referral approval prior to scheduling appointments
- Manage patient referral process (e.g., review for duplicates, ensure referral is sent to appropriate provider, follow-up with requesting provider to recommend changes)
- Ensures patient scheduling/follow up activities are completed according to federal, state, or organizational guidelines (e.g., referral guidelines, follow up notifications, PCP follow up)
- Draft/provide written communications to patients (e.g., standard letters, welcome letters, educational materials) in compliance with company and health plan guidelines
- Make calls to doctor's office on patient's behalf to schedule, check progress, and facilitate the care process
- Identify resources available to support patient care (e.g., housing, social services, meals)
- Maintain open communication and rapport with physicians to promote patient services/care
- Screens/forwards incoming calls from patients, physicians, and health plans
- Monitors, the no-show and other work queues
- Accurately enter patient demographics, guarantor, and coverage information into Epic EMR
- Accurately change filing order, ensure necessary adjustments are listed on account, distribute payments to correct service dates and request changes if needed
- Attend meetings regarding team/department updates, etc
- Assist insurance companies/guarantors with questions regarding charges and balances
- Work with other departments to resolve issues affecting reimbursement
- Going through faxes
- Scanning all documents in Epic
- Creating and/or Responding to Letters and Forms
- Other assigned duties
Skills
- High school diploma/GED
- 1+ year of healthcare experience using Epic or similar EMR
- Must reside in Kansas, Ohio, Missouri or Indiana
- Demonstrate understanding of relevant health plan guidelines and benefits (e.g., Medicare, Medicaid/Medical, commercial benefit plans, Federal/local government regulations)
- Demonstrate understanding of Federal privacy regulations (e.g., HIPAA)
- Demonstrate knowledge of safety guidelines/practices (e.g., OSHA)
- Demonstrate knowledge of basic medical terminology and human anatomy to document patient information using standard language/medical terminology
- Work from home experience
Benefits
- Comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase
- 401k contribution
- Remote role; candidates must reside in Kansas, Missouri, Indiana or Ohio
- Full-time employment
Company Overview
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