Clinical Administrative Coordinator

UnitedHealth Group; Dallas (TX); Remote; USD 25,000 - 44,000; Full time

Benefits offered by this job

Telecommuting policy

Remote work flexibility

Job summary

UnitedHealth Group is seeking a Clinical Administrative Coordinator for a nationwide remote role. You will support claims processing and clinical review workflows, coordinating with nurses and teams to ensure timely, accurate processing.

The position requires 18+ years old, high school diploma or equivalent, and 1+ years in an office or healthcare setting. Flexible shifts and full-time hours are available to support our diverse operations.

Qualifications

• High School Diploma / GED OR equivalent work experience.
• Must be 18 years of age OR older.
• 1+ years of professional office/customer service/healthcare experience.
• Familiarity with Windows PC applications and ability to learn new systems.
• Ability to stay focused and productive with repetitive tasks.
• Flexibility to work outside standard hours.
• Commitment to full-time (40 hours/week) with varied 8-hour shifts.

Responsibilities

• Meet productivity, schedule adherence, and quality standards while maintaining attendance.
• Review and determine if claims meet criteria for review.
• Determine if claims can be allowed or need clinical review.
• Set up cases, document information, and send for nurse clinical review.
• Complete templates with information and rationale.
• Work with team to solve problems and handle priorities.
• Collaborate to resolve complex issues and multi-task.

Skills

Clerical/administrative support

Office environment

Customer service

Windows PC proficiency

Attention to detail

Flexibility

Tools

COSMOS

FACETS

MACES

Job description

Improve the lives of others while Caring. Connecting. Growing together.

Job Description - Clinical Administrative Coordinator (2395263)

Clinical Administrative Coordinator (2395263)

This position is National Remote. You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

You dream of a great career with a great company – where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it’s a dream that can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.

This opportunity is with one of our most exciting business areas: Optum – a growing part of our family of companies that make UnitedHealth Group a Fortune 5 leader.

Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions, and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.

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 7:00 am - 5:00 pm local time. It may be necessary, given the business need, to work occasional overtime.

This will be on the job training and the hours during training will be aligned with your schedule.

Primary Responsibilities:

• Constantly meet established productivity, schedule adherence, and quality standards while maintaining good attendance
• Review, research and determine if claim meets criteria for review
• Review, research and determine if claim can be allowed or requires further clinical review
• Sets up case, document required information and send for clinical review by nurse
• Complete template with appropriate information and rationale
• Moderate work experience within own function
• Works with team to solve complex problems
• Prioritizing and multi-tasking
• Team oriented
• Other duties as assigned by manager and / or director

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 equivalent work experience
• Must be 18 years of age OR older
• 1+ years of professional experience in an office, customer service, or healthcare environment
• Familiarity and fluency with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
• Ability to remain focused and productive each day though tasks may be repetitive
• Flexibility to work outside standard hours of operations due to changing business need
• Ability to work full time (40 hours / week), Monday - Friday. Employees are required to have flexibility to work on any of our 8-hour shift schedules during our normal business hours of 7:00 am - 5:00 pm local time. It may be necessary, given the business need, to work occasional overtime

Preferred Qualifications:

• 1+ years of experience with COSMOS, FACETS, or MACES
• Clerical OR administrative support background
• Knowledge of ICD-10 and CPT codes
• Familiar with Medical Terminology
• Experience working with claims platforms and / or authorizations systems
• Experience with medical claims processing / research

Telecommuting Requirements:

• 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

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $18- $32 hourly based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

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

Job

Clinical Admin & Processing

Other Locations

US-CT-Hartford, US-MN-Minneapolis, US-AZ-Phoenix, US-FL-Tampa

UnitedHealth Group is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need special assistance or accommodation for any part of the application process, please call 1-866-566-8715 to be connected to Recruitment Services. Recruitment Services hours of operation are 7 a.m. to 7 p.m. CT, Monday through Friday.

UnitedHealth Group is a registered service mark of UnitedHealth Group, Inc. The UnitedHealth Group name with the dimensional logo, as well as the dimensional logo alone, are both service marks for the UnitedHealth Group, Inc.

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.