Job Abstract

If you are in San Diego, CA, you will have the flexibility to work from home and the office in this hybrid role* as you take on some tough challenges.

Optumis 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 startCaring. Connecting. Growing together.

The Clinical Administrative Coordinator provides routine administrative support to Utilization Management Department. Including but not limited to answering provider lines, working collaboratively with other departments, and demonstrating exceptional customer service. The Clinical Administrative Coordinator plays a key role in building professional relationships with external stakeholders and internal customers. Start training in office then opportunity to telecommute up to 3 days a week from home, as business needs and subject to change.

This position is 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 9am - 6pm PST. It may be necessary, given the business need, to work occasional overtime.

Our office is located at3131 Camino Del Rio N San Diego, CA 92108. Employees will be required to work 2 days onsite and 3 days from home. (5x a week during training)

We offer 4-8 weeks of paid training.Training will be conducted onsite.

*All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy.

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), ECT requests, Psychological Testing.
• Data entry of client information into several designated databases and County of San Diegos 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 Utilization Management 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.
• 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.
• 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.

Youll 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 equivalent work experience.
• Must be 18 years of age or older
• 1+ years of customer service experience analyzing and solving customer problems OR experience in healthcare industry.
• 1+ years of Data Entry experience in an administrative or clerical support role
• Microsoft Word (ability to create, edit, save, and send utilizing)
• Microsoft Excel, Adobe, and other programs. (ability to create, edit, save, and send utilizing)
• Abilityto type 50+ WPM, accurately.
• Experience handling confidential client / patient information.
• Abilityto navigate a PC to open multiple applications, send emails, and conduct data entry.
• Abilityto obtain and maintain access to the County of San Diego's electronic health records - Cerner Community Behavioral Health (CCBH) and WITS.
• 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 9am - 6pm PST. It may be necessary, given the business need, to work occasional overtime.
• Ability work on-site 5 days per week (during training) based on business need.

Preferred Qualifications:

• Experience working with health care insurance.
• Experience working in a hospital, physician's office or medical clinic setting.
• Working knowledge of Medical Terminology to communicate with members and providers.
• Experience working with ICD-10and CPT codes.
• Experience working with Medicare and / or Medicaid Services.
• Experience working in a call center environment.

Telecommuting Requirements:

• Reside within commutable distance of 3131 Camino Del Rio N San Diego, CA 92108
• 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.

California Residents Only:The hourly range for this is $16.54 - $32.55 per hour.Pay is based on several factors including but not limited tolocal labor markets, education, work experience, certifications, etc.UnitedHealth Group complies with all minimum wage laws as applicable. 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, youll find a far-reaching choice of benefits and incentives.