Job Description

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 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.

The Clinical Administrative Coordinator is responsible for reviewing and processing requests for prior authorization, referrals, or denials in accordance with insurance provider guidelines. This role requires a solid understanding of healthcare insurance policies, pharmacy benefit management, and medical terminology.   

Location: 1625 Medical Center Point, Colorado Springs, CO

Primary Responsibilities:

• Acquire and maintain a working knowledge of health plan formulary and authorization requirements

• Utilize systems to facilitate faster turnaround time on a complete authorization

• Gather necessary information from chart review to submit prior auth request to insurance providers

• Act as a liaison between providers, pharmacy, health plans and patients to support a timely medication authorization process

• Communicate with providers, pharmacy, and patients to provide updates on the status of their prior auth request

• Document in the patient electronic health record all medication authorization work provided following standard work guidelines

• Provide and document in EPIC medication authorization denials and health plan recommendation and or alternatives when provided

• Assist with front office tasks as needed

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 higher)

• 1+ years of customer service experience

• Intermediate level of proficiency in Microsoft Office applications including Excel, Word and Outlook 

Preferred Qualifications:

• 2+ years of experience in health care, including understanding of health plan related operations

• Experience in Managed Care 

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 $16.00 to $27.69 per hour 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 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 #RED

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