Clinical Administrative Coordinator for 11 years' experience, working with providers and members regarding medical and insurance benefits. I have a broad range of years in customer service experience analyzing and solving customer problems
Overview
12
12
years of professional experience
Work History
Clinical Administrative Coordinator
Optum, UnitedHealth Group
11.2012 - Current
Coordinates precertification, prior authorization and post service request, and provider correspondence for both Medicare and Medicaid members
Receives and reviews all incoming referrals ensuring completeness and accuracy
Conducts the clinical screening process and authorizes the initial set of sessions to provider and checks benefits
Refers cases requiring clinical review to a Nurse Reviewer
Verify appropriate ICD-10 and CPT coding usage on member prior authorizations
Coordinates precertification, prior authorizations for Durable Medical Equipment
Director of Clinical Quality and Patient Safety at Optum (UnitedHealth Group)Director of Clinical Quality and Patient Safety at Optum (UnitedHealth Group)