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Clinical Administrative Coordinator - Cypress, CA

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Optum

Jul 30

Applications are closed

  • Job
    Full-time
    Entry, Junior & Mid Level

Requirements

  • High School Diploma / GED
  • Must be 18 years of age or older
  • Proficient with Microsoft Suite
  • Ability to work 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 8am - 5pm. It may be necessary, given the business need, to work occasional overtime.
  • Customer Service/Call Center experience
  • Healthcare experience
  • Transplant Experience
  • Reside within commutable distance of 5701 Katella Ave Cypress, CA 90630
  • 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.

Responsibilities

  • Serve as primary point of contact for providers or members regarding medical/behavioral/clinical services or benefits.
  • Extract and review fax requests for medical or clinical services.
  • Receive calls requesting medical/behavioral/clinical services or benefits information (e.g., from providers or members).
  • Receive electronic referral form requests for medical/behavioral/clinical services.
  • Utilize phone system to respond to and transfer calls to appropriate individuals.
  • Ask callers standard questions to understand requests, gather necessary information, and assess urgency.
  • Access electronic member files using policy or id number.
  • Determine member eligibility.
  • Follow protocols to task requests appropriately.
  • Check procedure codes against notification requirements and benefit coverage to determine next steps.
  • Reference automated job aid tools via the computer to identify appropriate procedures when needed.
  • Access claims information.
  • Review and interpret call history documentation. (e.g., case notes)
  • Navigate between computer screens and platforms to research information. (e.g., medical, clinical, or benefits information)
  • Take calls and questions from members and/or providers regarding case status.
  • Determine whether authorizations are required for requested medical services.
  • Reference automated job aid tools via computer to research relevant rules, regulations, or procedures.
  • Learn computer system and process changes and updates and incorporate into daily work.
  • Contact internal resources if necessary to clarify information.
  • Identify appropriate resource (e.g., doctor, resource, contracted provider) to respond to medical requests.
  • Provide/explain benefit information to members/providers.
  • Provide/explain authorization information to members/providers.
  • Communicate with clinical team to ensure provider receives a response when necessary.
  • Document call history information into relevant computer system.
  • Enter medical request data into relevant computer system.
  • Follow standard procedures to complete requests.
  • Request medical review via relevant computer system as needed.
  • Review and advise member/provider of status of a request (e.g., notification, authorization)
  • Schedule appointments for members based on request.
  • Provide information regarding appointments and medical services to facilities staff to assist members.

FAQs

What is the location of the Clinical Administrative Coordinator position?

The position is located at 5701 Katella Ave, Cypress, CA 90630, and it offers a hybrid work arrangement that includes both remote and onsite days.

What are the working hours for this role?

The position requires full-time availability with flexible 8-hour shift schedules during the normal business hours of 8 AM to 5 PM, Monday to Friday. Occasional overtime may be necessary depending on business needs.

Is training provided for this position?

Yes, comprehensive training is provided for 2-4 weeks, during which the hours are from 8 AM to 5 PM PST, Monday through Friday.

What are the primary responsibilities of the Clinical Administrative Coordinator?

The primary responsibilities include serving as the main contact for providers and members regarding medical/behavioral services, managing incoming calls and requests for services, processing referrals and prior authorizations, and providing information about benefits.

What are the required qualifications for this job?

The required qualifications include a High School Diploma or GED, being 18 years of age or older, proficiency with the Microsoft Suite, and the ability to work full-time with flexible hours.

Are there any preferred qualifications for applicants?

Yes, preferred qualifications include customer service or call center experience, healthcare experience, and experience related to transplant services.

What telecommuting requirements must be met for this position?

Applicants must reside within a commutable distance from the Cypress office, have a secure dedicated workspace that provides privacy, and must be able to maintain a high-speed internet connection.

What is the salary range for this position?

The hourly pay range for the Clinical Administrative Coordinator position is between $16.54 and $32.55 per hour, based on several factors including local labor markets, education, and work experience.

How does UnitedHealth Group approach diversity and inclusion in their hiring practices?

UnitedHealth Group is committed to creating a diverse work environment and is an Equal Employment Opportunity/Affirmative Action employer, ensuring that all qualified applicants receive consideration without regard to various protected characteristics.

Is there a drug testing requirement for this position?

Yes, candidates are required to pass a drug test before beginning employment at UnitedHealth Group.

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Optum

Science & Healthcare
Industry
10,001+
Employees

Mission & Purpose

Optum is a health services and technology company that provides a wide range of solutions to improve healthcare delivery and outcomes. They offer services in healthcare management, data analytics, pharmacy benefit management, and technology solutions to healthcare providers, payers, employers, and government agencies. Optum's ultimate mission is to improve the health system's efficiency and effectiveness, creating a healthier world for everyone. Their purpose lies in collaborating with healthcare partners to address complex challenges, such as improving care coordination, reducing healthcare costs, and enhancing patient experiences. By leveraging data-driven insights and innovative technology, Optum aims to empower healthcare professionals and organisations to deliver high-quality, patient-centered care and drive positive healthcare outcomes for individuals and communities worldwide.

Culture & Values

  • Integrity

    Honour commitments. Never compromise ethics.

  • Compassion

    Walk in the shoes of people we serve and those with whom we work.

  • Relationships

    Build trust through collaboration.

  • Innovation

    Invent the future, learn from the past.

  • Performance

    Demonstrate excellence in everything we do.

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