Clinical Administration Coordinator

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 Inbound Support Associate is responsible for handling incoming calls from healthcare providers regarding medical claim review inquiries, denial explanations, and claims review status updates. The associate reviews denial reasons as outlined by the internal claims review team and provides accurate, compliant, and provider-friendly guidance on the next steps required to resolve issues.

Our team consists of experienced associates who manage inbound calls from healthcare providers. For the past five years, the team has been responsible for assisting providers with claims review status, denial explanations, and guidance on the next steps required to ensure accurate and timely claim resolution.

We operate in close collaboration with our counterparts in the USA, Puerto Rico, and the Philippines, ensuring seamless communication and consistent process execution. Through this multi-site partnership, the team maintains high service quality, solid adherence to compliance standards, and a unified approach toward resolving provider concerns efficiently and professionally.

Primary Responsibility

• Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so
  
  

• Any degree
• 6+ months of international voice process