Clinical Administrative Coordinator - National Remote

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 10:00 am - 8:00 pm CST. It may be necessary, given the business need, to work required overtime in the first 6 weeks of the year with occasional Saturdays. This will be paid on-the-job training and the hours during training will be 8:00 am - 5:00 pm CST, Monday - Friday. You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Point of contact for providers or members regarding medical/pharmacy/clinical services or benefits Review fax and electronic referral requests for medical or clinical services Enter medical request data into relevant computer system Utilize phone system to respond and transfer inbound calls transfer calls to appropriate individuals Access electronic member files in external portal using appropriate patient identification Review benefits and authorization requirements from the central BA team, create additional pharmacy test claims (if applicable), and patient responsibility Check procedure codes against notification requirements and benefit coverage to determine next steps Reference job aid tools via the computer to identify appropriate procedures when needed Document, review and interpret historical documentation (e.g., MAR, H &P) Navigate between computer screens and platforms to research information (e.g., medical, clinical, or benefits information) Reference and follow automated job aid tools via computer to research relevant rules, regulations, or policy/procedures Learn computer systems and process changes and updates and incorporate them into daily work Participate in routine meetings with team and branch members and update the team with relevant patient information Contact internal resources if necessary to clarify information Identify appropriate resources (e.g., doctor, resource, contracted provider) to respond to medical requests Provide/explain benefit information to providers and patients Obtain verbal and written consent (PSA) to treat patients Collect patient pay portions upon admission to services Communicate with multidisciplinary teams to ensure coordination is complete for the onboarding of the patient Review and advise member/provider of status of a request (e.g., notification, authorization) Perform patient onboarding tasks in the Cloud workflow within the approved turnaround times Update and/or add prescribers during the onboarding process Add other duties as assigned You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

High School Diploma/GED OR equivalent work experience 2+ years of experience with analyzing and solving customer problems 2+ years of experience working in the Health Care Industry Ability to work 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 10:00 am - 8:00 pm CST. It may be necessary, given the business need, to work required overtime in the first 6 weeks of the year with occasional Saturdays Must