Clinical Administrative Coordinator - National Remote

NHSHP; Lenexa, Northern (KS, KY); Hybrid; USD 25,000 - 44,000; Full time

Benefits offered by this job

Comprehensive benefits package

Equity stock purchase plan

401k contribution

Job summary

UnitedHealth Group is seeking a customer support professional to serve providers or members regarding medical, pharmacy, clinical services, or benefits, in a full-time role across the United States. The position emphasizes accurate data entry, effective communication, and coordination with internal teams to support patient care.

Responsibilities include reviewing referrals, handling inbound calls, and onboarding patients while complying with policies and privacy requirements.

Qualifications

• High School Diploma/GED or equivalent work experience
• 2+ years of experience analyzing and solving customer problems
• Ability to work full-time (40 hours/week) Monday - Friday, with 8-hour shifts during 10:00 am - 8:00 pm CST and possible overtime in weeks 1–6 with occasional Saturdays
• Must be 18 years or older

Responsibilities

• Serve as 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 systems
• Respond to inbound calls and transfer to appropriate teammates
• Access electronic member files in external portals using patient identifiers
• Review benefits and authorization requirements and determine next steps for claims and authorizations
• Reference job aid tools to identify procedures and ensure policy compliance
• Document and interpret clinical and historical records (e.g., MAR, H&P)
• Collaborate with multidisciplinary teams to coordinate patient onboarding and care
• Communicate benefit information to providers and patients and collect patient payments when applicable
• Maintain privacy and security of sensitive documents and data
• Contribute to team meetings and provide updates on patient statuses
• Maintain and update prescribers during onboarding processes
• Perform other duties as assigned

Job description

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.

Primary Responsibilities

• 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.

Required Qualifications

• High School Diploma/GED OR equivalent work experience
• 2+ years of experience with analyzing and solving customer problems
• 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 be 18 years OR older

Preferred Qualifications

• 2+ years of experience working in the Health Care industry
• 1+ years of experience working with Health Care Insurance
• 1+ years of experience in a Hospital, Physician's Office, OR Medical Clinic setting
• 1+ years of experience working with Medicare and / OR Medicaid Services
• 1+ years of experience in clerical OR administrative support background OR working in a Call Center environment

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 Telecommuters 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 hourly pay for this role will range from $18 - $32 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

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 make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

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.

#RPO #GREEN