Clinical Administrative Coordinator

About the role

Under the supervision of the Referral Management Center Supervisor, the Clinical Administrative Coordinator is responsible for the daily coordination of referral processes and other duties as assigned. This position is full-time, Monday through Friday, with normal business hours of 8:00am to 5:00pm. Flexibility to work at two other locations in Albuquerque may be required based on business needs.

This is a high-volume, customer service environment requiring efficiency, productivity, and thoroughness when dealing with members over the phone. You must also be able to work a flexible schedule that includes evening hours.

Responsibilities

• Manage the internal and external referral process and daily referral reconciliation, gathering required information and documents in compliance with established timelines.
• Handle administrative intake of members.
• Maintain department records as requested by supervisor, department director, and/or regulatory agencies.
• Receive all requests for exam (CD) check-out and process requests according to protocol.
• Receive and process in the RIS all outside facility incoming exams.
• Download all outside facility exams in PACS.
• Prepare and process all outside facility exams for return to facility or patient.
• Process all returned exams.
• Maintain CD files and purge outdated exams.
• Request pertinent prior exams for all modalities per protocol.
• Work with hospitals, clinics, facilities, and the clinical team to manage requests for services from members and/or providers.
• Process incoming and outgoing referrals and prior authorizations, including intake, notification, and census roles.
• Assist clinical staff with setting up documents and triage cases for Clinical Coverage Review.
• Handle resolution and inquiries from members and/or providers.
• Perform all other related duties as assigned.

Requirements

• High School Diploma or GED.
• 2+ years of customer service experience.
• Intermediate proficiency in Microsoft Office applications including Excel, Word, and Outlook.

Preferred Qualifications

• Experience working within the healthcare industry and with healthcare insurance.
• Experience working in a hospital, physician's office, or medical clinic setting.
• Knowledge of ICD-9 and CPT codes.
• Previous experience working in radiology.
• A clerical or administrative support background.
• Previous experience working within an Electronic Health Record (EHR) system.
• Demonstrated ability to manage and respond effectively to high call volumes.
• Working knowledge of medical terminology and clinical documentation.

Benefits

In addition to your salary, UnitedHealth Group offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution (all benefits are subject to eligibility requirements).

Pay

For California residents, the hourly range is $18.00 to $32.00 per hour. Pay is based on several factors including but not limited to education, work experience, and certifications.