SENIOR CLINICAL ADMINISTRATIVE COORDINATOR - PHOENIX, AZ
Company: Optum
Location: Sun City West
Posted on: October 25, 2024
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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. Positions in this function are
responsible for daily billing/creating invoices, supporting patient
pay activities and financial counseling, and responding and
resolving to denials received. You will work with OptumRx Infusion
Services, which helps patients with infused intravenous
medications. As a Clinic Administrative Coordinator, you will be
working in a new clinic opening with Optum Infusion and will be
responsible for the back-end billing duties. You will create
invoices, follow up on denials, work with the corporate billing
team as needed and also handle patient calls to answer questions
related to their billing and collections. This position is
full-time, Monday - Friday. Employees are required to work our
normal business hours of 8:00 AM - 8:00 PM EST. Our office is
located at 20414 North 27th Ave, Suite #450, Phoenix, AZ, 85027. We
offer 1-2 weeks of on-the-job training. The hours of training will
be aligned with your schedule. Primary Responsibilities: Daily
Billing:Reviews open delivery tickets and prioritize billing
activities. Creates invoices that are accurately generated and
submitted on a timely basis. Identifies any trends or billing
inaccuracies with investigation and resolution, escalating to
Supervisor/Manager when assistance is needed. Completes account
reviews/correction requests submitted by other departments within
established turnaround times. Work closely with front office and
prior authorization team to maximize reimbursement Adheres to
Regulatory / Payor Guidelines and policies & procedures. Provides
exceptional customer service to internal and external customers.
Develop relationships with payers to assist with billing and
resolve root causes of issues Understands how to research and work
closely with insurance carriers for reimbursement requirements
Provide exceptional Customer service to patients and support the
patient pay team. Enter patient payments, prepare deposits, and
balance daily deposit log/ledger Adhere to Regulatory / Payer
Guidelines and policies & procedures. Other duties as assigned.
Financial Counseling:Discuss insurance coinsurance, copays and
deductibles with patients and educate them on their insurance
coverage as needed Obtain consent and populate financial assistance
program applications and copay applications on patients behalf
Obtain financial information and signatures from patients when
requested by foundations Set up, edit, and maintain payment
arrangements in advance or post treatment of patients Properly
document all conversations in applicable systems Other duties as
assigned Denials/Collections:Responsible for the accurate and
timely response to denials received. Researching and resolving
denials from upstream issues through receiving payment on the
claim. Ability to work through various scenarios independently.\
Analyzes daily denial management correspondence to appropriately
resolve issues Have a vast understanding of the claim life cycle
Assure that timely and accurate follow up activity is performed on
all invoices that are not paid within 45 days of submission.
Responsible for review and documenting of key accounts. Ensures
timely payment by identifying denial trends Ability to read and
interpret LCD/NCD requirements in regard to CPT and HCPCS denials
Identify payer performance trends at the payer level Capable of
navigating payer portal Identifies bad debt write-offs and
adjustments Process refunds as identified to meet payer guidelines
Adheres to regulatory/payer guidelines and policies and procedures
Provides exceptional customer service to internal and external
customers Other duties as assigned Other Roles and
Responsibilities:Greeting and checking-in patients as they arrive
to our centers Verifies patient insurance information upon check-in
Copies insurance cards and driver's license for all new patients
Collects patient paperwork and enters patient information into
systems, ensuring patient information is accurate and up-to-date
Answer calls within the center and market as appropriate General
center support i.e. light cleaning, supply ordering/stocking, etc.
Receiving packages and mail as appropriate 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 Knowledge of explanation of benefits (EOB) Knowledge of
CPT, ICD-10, and HCPCPS coding Billing and Collection experience
Knowledge of benefits verification and prior authorization Ability
to work 40 hours per week, any shift between the hours of 8am - 8pm
EST, Monday - Friday Preferred Qualifications: Experience in
Microsoft Excel (create and edit spreadsheets) Experience in
Microsoft Word (creating, editing, saving, formatting) Experience
with Specialty drug and infusion billing in a hospital, HOPD, or
community based clinic setting. Minimum 2+ years working with
medical billing /medical collections, and/or accounts receivables,
patient pay Minimum 2+ years working in Microsoft office,
specifically Microsoft Excel, Microsoft Outlook, and Microsoft
Word. Ability to read and interpret payer contracts and billing
guidelines 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. 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. #RPO #RED --s-p-m1-- By applying, you
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Keywords: Optum, Gilbert , SENIOR CLINICAL ADMINISTRATIVE COORDINATOR - PHOENIX, AZ, Administration, Clerical , Sun City West, Arizona
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