Associate Clinical Admin

Our client operates in the healthcare sector, focusing on improving health outcomes by connecting individuals with care, pharmacy benefits, data, and resources. The organization addresses challenges related to health equity, aiming to reduce barriers to good health for diverse populations. It leverages technology and comprehensive services to impact millions of people, with a commitment to diversity, inclusion, and advancing equitable healthcare.

About the Opportunity

The Associate Clinical Admin role involves managing the ancillary referral process, including handling orders and prior authorizations. This position serves as a key point of contact for referrals, ensuring proper scheduling, communication, and documentation. The role contributes directly to the efficient delivery of healthcare services by supporting patient access to medical resources and enabling accurate billing.

Responsibilities

• Manage ancillary referral process by handling incoming and outgoing orders and prior authorizations
• Serve as primary contact for referrals via telephonic and electronic communication with clients and vendors
• Determine patient eligibility and appropriately task requests according to protocols
• Navigate computer systems and applications to research information
• Assess whether authorizations are required for medical services
• Use automated tools to research relevant rules, regulations, or procedures
• Contact appropriate resources to clarify information and respond to medical requests
• Schedule appointments and provide information about appointments and medical services to patients
• Order supplies and durable medical equipment through appropriate vendors
• Ensure orders are entered correctly for billing submission
• Complete performance targets (e.g., six orders per day for provisioners, 45 for intake associates)

Requirements

• High School Diploma, GED, or equivalent work experience
• Minimum age of 18 years
• At least one year of experience in an office, claims, or customer service environment
• Experience in a metric-driven work setting
• Proficiency with Windows PC applications and ability to learn complex systems
• Ability to work full-time, Monday to Friday, 11:00 AM to 8:00 PM EST, with occasional overtime and weekends

Preferred Qualifications

• Knowledge of ICD-10 and CPT codes
• Call center experience
• Understanding of durable medical equipment (DME)

Telecommuting Requirements

• Secure handling of sensitive documents
• Dedicated work area separated from living spaces to ensure privacy
• Access to UnitedHealth Group approved high-speed internet connection

Skills

• Ability to manage and prioritize multiple tasks diligently
• Excellent verbal and written communication
• Strong organizational and time management skills

Pay

The hourly pay for this role will range from $16 to $29 per hour based on full-time employment.

Schedule

Full-time, Monday to Friday, 11:00 AM to 8:00 PM EST, with occasional overtime and weekends.