Clinical Administrative Coordinator - San Diego, CA

Full Time
San Diego, CA 92102
Posted
Job description

$750 Sign On Bonus For External Candidates

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.

This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 9 AM – 6 PM or 9:30 AM – 6 PM. It may be necessary, given the business need, to work occasional overtime. Our office is located at 3131 Camino Del Rio N, San Diego CA 92108.

Primary Responsibilities:

  • Data entry of authorization requests from Providers, including but not limited to: Treatment Authorizations Requests, Out of Network invoices, Retroactive Requests, Outpatient Authorization Requests, Day Service Requests, Therapeutic Behavioral Services, Intensive Home-Based Services, Therapeutic Foster Care Requests, Treatment Plans, Claims Assessments, Inpatient and Outpatient Pend Reports, and Interpreter Requests and Invoices, Notice of Adverse Benefit Determinations (NOABD), Outpatient and Inpatient ECT requests, 24-hour notifications, Psych Testing.
  • Data entry of client information into several designated databases and County of San Diego’s Electronic Heath Record (EHR) System.
  • Processing and tracking inpatient and outpatient authorization requests.
  • Processing high volume inpatient and outpatient authorizations within established turnaround times and serving as back up for other Clinical Administrative Coordinator processes depending on staff availability.
  • Distribute appropriate work products to licensed clinicians for clinal review.
  • Add and/or update and validate demographic and diagnosis information in EHR.
  • Scanning of documents for retention and filing documents.
  • Purging documents.
  • Facsimile and photocopy duties; other assistance to team members as needed with overall direction from team lead, supervisor, or managers.
  • Efficiently respond to incoming calls and provide prompt and courteous service to customers and guests. External stakeholders include inpatient hospitals; Residential Substance Use Facilities; Crisis Residential Facilities; Providers; Billers; and County Stakeholders.
  • Sort through incoming e-faxes, incoming mail for department and incoming faxes through scanner.
  • E-filing of electronic inpatient and outpatient requests.
  • File data and perform other routine administrative tasks as assigned for other sub teams as needed.
  • Operate a variety of standard office machines, including PC and a variety of computer software, DYMO label, phone, fax, calculation, scanner, photocopy machine.
  • Interpret and respond clearly and effectively to verbal requests over the phone or in person, and to verbal or written instructions in a timely manner.
  • Establish and maintain effective professional relationships with internal and external customers.
  • Perform reception duties in an efficient, professional, and courteous manner as needed.
  • Pursue Common Language of Leadership/developmental goals to enhance skills and performance.
  • Cross train in Clinical Administrative Coordination/UM processes and provide support as needed.
  • Update processes when changes occur and/or as needed.
  • Perform front desk duties in an efficient, professional, and courteous manner as needed.
  • Accurately direct Optum visitors and incoming calls to appropriate staff member or department within Optum; take messages as needed.
  • Position requires access to electronic applications and documents which include Individually Identifiable Health Information and Personal Health Information.
  • Other duties as assigned by Clinical Manager or Clinical Support Services Supervisor.
  • Support other sub teams within Utilization Management as needed.
  • Support the San Diego Access and Crisis Line as needed.
  • Process in office paperwork products and mail received from providers.
  • Other duties as assigned by Clinical Manager or Clinical Support Services Supervisor.

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 higher)
  • 1+ years of office work and/or customer service experience or Experience in Healthcare industry
  • 2+ years of customer service experience
  • PC proficiency, preferably in a Windows environment
  • Experience in multiple databases, computer programs, Microsoft Excel (create and edit spreadsheets) and Microsoft Teams (chat, calendar, meetings, file storage, data entry)
  • Ability to pass background check, to obtain and maintain access to the County of San Diego’s electronic health records- Anasazi and WITS
  • Ability to work any of our 8-hour shift schedules during our normal business hours of 9 AM – 6 PM or 9:30am - 6:00pm. It may be necessary, given the business need, to work occasional overtime

Preferred Qualifications:

  • Experience working within the health care Industry and with health care insurance
  • Experience working in a hospital, physician's office or medical clinic setting
  • A clerical or administrative support background
  • Knowledge of ICD-9 and CPT codes
  • Experience working in a call center

Soft Skills:

  • Possess ability to type, enter accurate data in to designated databases
  • Experience working in a fast-paced environment, and innovative thinker

Careers with Optum . Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

California Residents Only: The salary range for California residents is $16.00 - $31.44.Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives

**PLEASE NOTE** The sign on bonus is only available to external candidates. Candidates who are currently working for a UnitedHealth Group, UnitedHealthcare or related entity in a full time, part time, or per diem basis ("Internal Candidates") are not eligible to receive a sign on bonus.

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.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

#RPO #RED

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