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Associate Patient Care Coordinator
Associate Patient Care CoordinatorOptum • Paradise, CA, US
Associate Patient Care Coordinator

Associate Patient Care Coordinator

Optum • Paradise, CA, US
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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

Primary 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
  • What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include :

  • 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.)
  • More information can be downloaded at :
  • 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 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
  • Preferred Qualifications :

  • 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)
  • Soft Skills :

  • Excellent communication skills and phone etiquette
  • 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.

    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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