Associate Patient Care Coordinator
About The Position
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. The Associate Patient Care Coordinator is responsible for the completion of set processes and protocols, working cooperatively with all members of the care team to support the vision and mission of the organization, delivering excellent customer service and adhering to Lean processes, and supporting the teams in meeting financial, clinical and service goals. Schedule: Monday – Friday, 8:00AM – 5:00PM Location: 2010 Goldring Ave, Las Vegas, NV 89106
Requirements
- High school diploma/GED (or higher)
- 1+ years of customer service experience
- 1+ years of experience with insurance programs and basic managed care principles such as referrals and prior authorization
- 1+ years of experience in a medical office
- 1+ years of experience with Nevada plan experience
- Intermediate level of proficiency in MS Word, Excel, and Outlook, including the ability to use multiple web applications
- Excellent communication skills and phone etiquette
Nice To Haves
- 1+ years of experience in a health care setting
- Knowledge/understanding of CPT/ICD-10 coding
- Ability to work in an office setting with patient contact during shift
- Experience in a high-volume medical clinic
- Work experience in Urology
- Knowledge of local HMO/PPO/Medicare plans
- Bilingual (English/Spanish)
Responsibilities
- Provide high level of customer service while communicating with internal departments and external provider office staff as pertains to performance of job duties
- Review and process prior authorization requests to meet departmental key indicator productivity
- Verifies patient insurance eligibility & benefits to include applicable co-pays, co-insurances, deductibles, Out of Pocket Maximum, appropriate service facilities, services covered and which services if any require prior authorization
- Demonstrate knowledge of insurances including navigating websites for online benefit reviews
- Answer incoming calls regarding benefits, eligibility, authorizations & referrals as well as other inquiries as it relates to health insurance and acts as Patient Advocate
- Process adverse determinations; timely notification and thorough documentation
- Respond to complex customer calls
- Resolve customer service inquiries which could include: Benefit and Eligibility information Authorization for treatment Specialists Orders/Referrals
- Must be able to work independently
- Submit Specialists Referrals with appropriate clinical information using established protocols & procedures
- Exceed attendance standards set by company policy
- Take responsibility of problem solving
- Any other duties that may arise
Benefits
- Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
- Medical Plan options along with participation in a Health Spending Account or a Health Saving account
- Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
- 401(k) Savings Plan, Employee Stock Purchase Plan
- Education Reimbursement
- Employee Discounts
- Employee Assistance Program
- Employee Referral Bonus Program
- Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
