Senior 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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. 

The Senior Clinical Administrative Coordinator from the perspective of both the front-end specialist and the collector/billing rep, to confirm a path to payment. Pursue resolution for BV, Auth, Medical Necessity, Coordination of Benefits, CoPay Assist, and various insurance and documentation denials. Responsible for the accurate and timely follow-up of authorizations being entered into the binoculars, including research, document collection, review of accuracy and notification to appropriate teams. Identify trends and report those trends to leadership for resolution and to reduce authorization adjustments. 

This position is full time (40hours/week) Monday – Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00am – 7:00pm CST. It may be necessary, given the business need, to work occasional overtime.  

This will be on the job training and the hours during training will be 7:00am to 7:00pm CST, Monday – Friday.

   

Primary Responsibilities:

• Review Denials related to BV, PA, MedNec, Med Records, COB and other denials from all payers. 
• Proven ability to do root cause analysis and associated troubleshooting. 
• Provide guidance on correcting denials to lead to a path to payment. 
• Follow up with both Front End and/or RCM team members to ensure prompt/timely payment and escalate issues as necessary. 
• Evaluates timely filing. 
• Assist with payer projects. 
• Initiate requests to RCM for next action. 
• Adheres to Regulatory / Payor Guidelines and policies & procedures. 
• Provides exceptional customer service to internal and external customers. 
• Performs quality analysis to identify and report trends, along with individual and department training opportunities. 
• Other duties as assigned. 

   

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 OR older 
• 2+ years of experience analyzing and solving customer problems
• 2+ year(s) of Home Infusion Accounts Receivable or Home Infusion Benefit Verification or Home Infusion Prior Authorization Experience. 
• Basic level skill in Microsoft Excel 
• Basic level skill in Microsoft Word  
• Intermediate Outlook experience
• Ability to work full time (40hours/week) Monday – Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00am – 7:00pm CST. It may be necessary, given the business need, to work occasional overtime.

   

Preferred Qualifications:

• Home Infusion front end experience to include benefits verification and prior authorization.   
• Experience working with health care insurance
• Experience in a hospital, physician’s office or medical clinic setting
• Clerical or administrative support background or experience working in a call center environment
• Experience working with Medicare and/or Medicaid Services

   

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 salary for this role will range from $20.00 – $35.72 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.

   

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