Healthcare Customer Service Rep - Phoenix, AZ

    • Phoenix, AZ

Position Description

Talk about meaningful work. Talk about an important role. Let's talk about your next career move. Due to our expanding business, Optum is seeking Clinical Administrative Coordinators who share our passion for helping others live healthier lives. As one of the world's leading health care companies, Optum is pursuing innovative new ways to operate our service centers and improve on our ability to deliver high - quality care. As part of our clinical support team, you will be a key component in customer satisfaction and have a responsibility to make every contact informative, productive and positive for our members and providers. You'll have the opportunity to do live outreach, educating and assisting providers about program benefits and services while also helping to manage member cases. Bring your skills and talents to a role where you'll have the opportunity to make an impact on a huge scale. Take this opportunity and begin doing your life's best work.(sm)

What makes your clinical career greater with Optum? You'll work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere.

Must be able to work a scheduled shift (8 hours per day / 40 hours per week) Monday - Sunday, between the hours of 5:00 am PST and 7:00 pm PST

Primary Responsibilities:

  • Take inbound calls from providers in a call center environment
  • Work with hospitals, clinics, facilities and the clinical team to manage request for services from members and / or providers
  • Manage the referrals process, processing incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles
  • Provide appropriate triage and care coordination notification cases for non - clinical assessment / intervention
  • Process notification requirements
  • Assist the clinical staff with setting up documents / triage cases for Clinical Coverage Review
  • Handle resolution / inquiries from members and / or providers that may include:
  • Benefit and Eligibility information
  • Billing and Payment issues
  • Customer material requests
  • Physician assignments
  • Authorization for treatment
  • Explanation of Benefits (EOB)
  • Verifying appropriate ICD - 10 and CPT coding usage


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
  • 1+ years of customer service experience analyzing and solving customer problems
  • 1+ years of call center experience
  • Must be able to navigate a PC to open applications, send emails, and conduct data entry
  • Ability to work a scheduled shift (8 hours per day / 40 hours per week) Monday - Sunday, between the hours of 5:00 am PST and 7:00 pm PST


Preferred Qualifications:

  • 2+ years of experience working within the Healthcare Industry
  • 1+ years of experience working with Healthcare Insurance
  • Experience working in a Hospital, Physician's Office, or Medical Clinical setting
  • Professional experience in a clerical or administrative support related role
  • Experience working with ICD - 9, ICD - 10, and CPT codes
  • Experience working with Medicare and / or Medicaid Services
  • Working Knowledge of Medical Terminology to communicate with members and providers


Soft Skills:

  • Ability to maintain set goals and metrics in a call center environment
  • Ability to communicate efficiently in a professional environment
  • Ability and willingness to work a set schedule, including clock-in/out, breaks, and lunches as designated by leadership


Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

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.

Job Keywords: Clinical Administrative Coordinator, Clinical Admin Coordinator, CAC, Clinical Admin, Clinical Coordinator, Coordinator, Call Center, Clinical, Healthcare, Customer Service Representative, Customer Service Rep, Customer Service, CSR, Patient Care, Phoenix, AZ, Arizona


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