SENIOR CLINICAL ADMINISTRATIVE COORDINATOR - PHOENIX, AZ
Company: Optum
Location: Sun City West
Posted on: October 23, 2024
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 reimbursementAdheres 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 issuesUnderstands how to research and
work closely with insurance carriers for reimbursement
requirementsProvide exceptional Customer service to patients and
support the patient pay team.Enter patient payments, prepare
deposits, and balance daily deposit log/ledgerAdhere 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 neededObtain consent and populate financial assistance
program applications and copay applications on patients
behalfObtain financial information and signatures from patients
when requested by foundationsSet up, edit, and maintain payment
arrangements in advance or post treatment of patientsProperly
document all conversations in applicable systems Other duties as
assignedDenials/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 issuesHave a vast understanding of the claim
life cycleAssure that timely and accurate follow up activity is
performed on all invoices that are not paid within 45 days
ofsubmission. Responsible for review and documenting of key
accounts.Ensures timely payment by identifying denial trendsAbility
to read and interpret LCD/NCD requirements in regard to CPT and
HCPCS denialsIdentify payer performance trends at the payer
levelCapable of navigating payer portalIdentifies bad debt
write-offs and adjustmentsProcess refunds as identified to meet
payer guidelinesAdheres to regulatory/payer guidelines and policies
and proceduresProvides exceptional customer service to internal and
external customersOther duties as assignedOther Roles and
Responsibilities:
Greeting and checking-in patients as
they arrive to our centersVerifies patient insurance information
upon check-inCopies insurance cards and driver's license for all
new patientsCollects patient paperwork and enters patient
information into systems, ensuring patient information is accurate
and up-to-dateAnswer calls within the center and market as
appropriateGeneral 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 experienceMust be 18 years of age or olderKnowledge
of explanation of benefits (EOB)Knowledge of CPT, ICD-10, and
HCPCPS codingBilling and Collection experienceKnowledge of benefits
verification and prior authorizationAbility 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/oraccounts receivables, patient
payMinimum 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 #REDBy applying, you consent to your
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Keywords: Optum, Sun City , SENIOR CLINICAL ADMINISTRATIVE COORDINATOR - PHOENIX, AZ, Administration, Clerical , Sun City West, Arizona
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