The organization operates globally within the healthcare industry, focusing on improving health outcomes through technology-enabled care. It serves over 2.5 million patients in the Pacific West region (California, Oregon, Washington), emphasizing health equity, affordability, quality, and convenience.
The Clinical Administrative Coordinator supports healthcare operations by providing administrative and clerical assistance. The role ensures timely processing of healthcare service requests, referral management, and benefits verification while maintaining compliance with legal and confidentiality standards. Supports care management to improve health outcomes.
Responsibilities include:
- Providing administrative and clerical support (telephone assistance, filing, typing, scheduling, correspondence distribution)
- Performing prospective and concurrent review of requested services per guidelines
- Documenting members’ service benefits by contacting health plans
- Directing providers and members to contracted provider networks and facilities
- Processing authorizations for HMO/PPO clients per procedures
- Entering, updating, and closing referrals daily ensuring eligibility, benefits, and accurate clinical data
- Processing referrals for durable medical equipment and coordinating home health services
- Routing referrals needing review to licensed Care Management staff for physician review
- Resolving issues and responding to requests from coordinators, staff, and providers
- Collaborating with Patient Services regarding member concerns
- Processing inter-facility transfer referrals and after-hours emergency/urgent care logs as needed
- Collecting and preparing medical records for review
- Assisting with phone calls, file maintenance, logs, and reports
- Handling protected health information compliant with HIPAA
- Assisting with insurance and benefits verification
- Participating in interdisciplinary rounds
Requirements:
- High School Diploma/GED or equivalent experience
- At least 18 years old
- Minimum 1 year experience in front/back office, coordinator, insurance, or medical group roles
- Ability to work 8-hour shifts (8:00am - 5:00pm PST) with occasional overtime and weekend shifts
- Secure remote workspace with high-speed internet
Preferred:
- 2+ years corporate healthcare office experience
- 1+ years insurance eligibility experience
- Intermediate proficiency with Microsoft Office Suite
The position is fully remote within the U.S.
- High School Diploma/GED or equivalent experience
- Minimum 1 year experience in relevant administrative or medical group roles
- Ability to work standard business hours with occasional weekends
- Secure dedicated remote workspace with high-speed internet
Preferred:
- 2+ years healthcare corporate office experience
- 1+ years insurance eligibility experience
- Intermediate Microsoft Office skills
Location
N/A
Employment Type
Full-time
Experience Level
Entry Level
Salary Range
$37,400 - $66,800
Remote work allowed
Yes
Posted
3 weeks ago