Clinical Administrative Coordinator (COLORADO SPRINGS)

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 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 request 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 : 1633 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 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 :

Preferred Qualifications :