Optum AZ - Remote Referral Coordinator

UnitedHealth Group Inc. - 30+ days ago

Like you, UnitedHealth Group is strong on innovation. And like you, we'll go the distance to deliver high-quality care. As part of our clinical support team, you will be a key component in customer satisfaction and have a responsibility to make every contact informative, productive and positive for our members and providers. You'll have the opportunity to do live outreach, educating members about program benefits and services while also helping to manage member cases. Bring your skills and talents to a role where you'll have a chance to make an impact.


Clinical Admin Coordinator is responsible for building, submitting, processing, and scheduling referrals from 4C Medical Group Providers for the purposes of obtaining Specialist care by our internal and external / network Specialty Providers. Works cooperatively with all members of the care team to support the vision and mission of the organization, deliver excellent customer service and adhere to Lean processes. Supports the teams in meeting financial, clinical and service goals.


Primary Responsibilities:




Provide exceptional service to all customers

Accept referrals and prior-authorization requests from Providers

Confirm all necessary documents and information has been provided to process the request

Responsible for ensuring demographics including insurance information are correct in EMR and update as necessary per Standard Work

Evaluate the urgency of referrals and prior-authorizations and process accordingly

Adhere to referral and prior-authorization SLAs

Communicate status to patients and inform them of any delays

Relay status to appropriate Provider, support staff, and member of management

Resolve service issues and complaints, and defer to appropriate management or clinical personnel when necessary

Assist co-workers and team members with duties when requested, to include but not limited to, floating to other areas or offices

Monday - FRIDAY, 7:45am-5pm, NO WEEKENDS, CLOSED on ALL MAJOR HOLIDAYS




Remote Position*

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 or equivalent

Good communication skills, excellent phone etiquette and customer service skills. Must possess computer skills, window based applications, organization skills

Experience with and the ability to navigate Windows, Outlook, Gmail, Excel, and EMR (electronic medical records system)

Experience using email and tasks as the primary communication tools between colleagues, supervisors, and providers

Solid understanding of the referral and prior-authorization process beginning to end. Ability to manage multiple STAT requests. Must have an understanding of health insurance carriers and their unique plans and processes. Must be able to resolve patient issues and problems in a positive manner

Must be willing and/or comfortable working in a fast paced adult medicine clinic

Must be willing to float to cover PTO / call offs

You will be provisioned with appropriate Personal Protective Equipment (PPE) and are required to perform this role with patients and members on site, as this is an essential function of this role

Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained

Preferred Qualifications:




1+ years of medical referrals or front office experience

Have a solid understanding of the referral and prior-authorization process beginning to end. Ability to manage multiple STAT requests. Must have an understanding of health insurance carriers and their unique plans and processes. Must be able to resolve patient issues and problems in a positive manner

Graduate of an accredited Medical Assistant school or have 3+ years of experience in the military as a Medical Assistant or equivalent

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)


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.


Job Keywords: Referrals, Referral Clerk, Medical Assistant, Customer Service, Clinic, Clinical Administrative Coordinator, Medical Office, Receptionist, Customer Service, Patient Care, Medical, Healthcare, Admitting and Registration Clerk, health care, Scottsdale, AZ, Arizona

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