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Clinical Administrative Coordinator - Remote in MST or CST

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Optum

Jan 14

Applications are closed

  • Job
    Full-time
    Junior Level
  • Customer Relations
    Healthcare
  • Dallas
    Remote

Requirements

  • High School Diploma / GED
  • Must be 18 years of age OR older
  • 1+ years of combined OR related experience in a healthcare, call center, and / OR customer service setting using the telephone and computer as the primary instrument to perform job duties
  • Proficiency with Microsoft Office Word (create and maintain documents), Microsoft Excel (create and maintain spreadsheets) and Microsoft Outlook (email and calendaring)
  • Ability to work 8-hour shift Sunday - Saturday, 9:00 am - 7:00 pm CST (shifts vary to support our 24hr 7 days a week operation)

Responsibilities

  • Managing authorizations / notifications and other service requests received via incoming phone calls, faxes and portal submission
  • Providing excellent customer service, including the ability to handle escalated callers
  • Determining authorization OR notification requirements
  • Preparing authorization cases for Medical Directors, Network Operations Nurses and Case Managers
  • Providing administrative approvals (depends on the line of business)
  • Handling expedited authorizations, authorization updates and status checks
  • Confirming member eligibility
  • Outreaches to providers and / OR Patient to complete authorization requests and prescriptions
  • Maintaining knowledge of various health plan partner benefits, networks, CMS regulations and health plan partner policies
  • Utilizing experience and judgement to plan, accomplish goals and effectively resolve each assigned task
  • Non-Clinical staff is not responsible for conducting any Network Operations activity that requires interpretation of clinical information
  • Performs all other related duties as assigned

FAQs

Do we support remote work?

Yes, this position is remote for candidates located in the CST or MST time zones.

What are the working hours for this position?

The role requires an 8-hour shift, Sunday to Saturday, from 9:00 am to 7:00 pm CST, with varying shifts to support our 24/7 operations.

Is training provided for this role?

Yes, training will be conducted virtually from home for 6-8 weeks, Monday through Friday from 8:00 am to 4:30 pm CST.

What qualifications are required for this position?

A High School Diploma or GED is required, along with 1+ years of related experience in a healthcare, call center, or customer service setting.

What skills are preferred for applicants?

Preferred qualifications include knowledge of medical terminology and familiarity with ICD-10 and CPT coding.

Is there a possibility for overtime?

Yes, it may be necessary to work mandatory overtime during peak seasons, which could be up to 2 hours per day.

Will I need to provide my own equipment to work remotely?

Yes, employees are required to have an established dedicated work area and must ensure a high-speed internet connection is available.

What is the pay rate for this position?

The hourly range for this role is $20.80 per hour, based on several factors including local labor markets, education, work experience, and certifications.

Is prior experience with Microsoft Office required?

Yes, proficiency in Microsoft Office Word, Excel, and Outlook is required.

Are applicants required to pass a drug test?

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

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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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