Clinical Administrative Support, HIM - Albuquerque, NM

Careers at UnitedHealth Group

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Compassion. It's the starting point for health care providers like you and it's what drives us every day as we put our exceptional skills together with a real feeling of caring for others. This is a place where your impact goes beyond providing care one patient at a time. Because here, every day, you're also providing leadership and contributing in ways that can affect millions for years to come. Ready for a new path? Learn more, and start doing your life's best work. SM

Our teams are helping people from around the world. We can bring out your best as you put your listening, analytical and problem solving skills to work in a setting that is geared to helping improve lives and enhance health care for millions. Here, you'll discover a wealth of pathways for professional growth within Customer Service, Billing, Claims, Enrollment & Eligibility and across our global economy. Join us and find out why this is the place to do your life's best work. SM

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

Administrative Clinical Support Tech works collaboratively with providers, clinical staff, and support departments to process medication refill requests and medication prior authorizations. Working as a member of the Rx Refill Support Center to conduct chart audits for medication renewals requested by either patients or pharmacies, processes prescription refill requests within the EHR application, resolving medication refill related issues or problems, obtaining medication prior authorizations, performing PMP validation and conducting outreach to patients and pharmacies regarding refill requests and outcomes. Additionally, serves as department support for the HIM department to assist with medical records processing and indexing as well as supporting Clinical Information Systems to conduct system and workflow testing and process improvements. Adheres to policies, procedures and regulations to ensure compliance and patient safety. Participation in Compliance and other important training is a condition of employment.

Primary Responsibilities:
  • Works as a member of the Rx Refill Support Center and HIM by processing prescription refill requests, resolving medication refill related issues or problems, outreach to patients and pharmacies regarding refill requests, obtaining medication prior authorizations and performing PMP validation
  • Responds effectively to incoming patient calls and communicates pertinent information to physician or designee to provide for continuity of optimal care
  • Appropriately communicates physician orders and medication instructions to patients
  • Analyzes medical requests to resolve medication refill related issues or problems
  • Assists with the testing of new applications, new components, and upgrades to existing systems and associated applications
  • Provides application-troubleshooting support for applications
  • Assists with testing per test plans reference: version upgrades, and any system modifications. Document all outcomes of testing. Monitor all application issues and evaluate and resolve issues as they arise
  • Write and maintain accurate and current documentation regarding application(s) supported by the team. Participate in the maintenance of training materials and disseminate materials to other groups per procedures
  • Documents pertinent patient information in the electronic medical record as it relates to job function
  • Electronically document scanning and indexing of PHI into the electronic medical record within 48 hours or receipt
  • Reviewing and routing electronic documents requiring clinical action to appropriate parties
  • Researching medical charts requiring additional actions such as duplicate record existence
  • Researching and assigning identifiers to payer records
  • Creating new patient records, verifying and making data corrections
  • Assisting patient with the electronic patient portal
  • Assisting with audits and electronic work queue management
  • Meets quality standards and productivity requirements and projects deadlines
  • Completing basic medical Assistant competencies in addition to department specific competencies
  • Performs and supervise clerical and administrative duties as directed
  • Consistently exhibits behavior and communication skills that demonstrate
  • commitment to superior customer service, including quality, care and concern with and every internal and external customer
  • Constantly meet established productivity, schedule adherence, and quality standards.
  • Actively participates in process improvement initiatives
  • Participates regularly in staff and departmental meetings
  • Uses, protects, and discloses patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
  • Performs other duties as assigned

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 or equivalent
  • 1+ years of experience. Experience could be any combination in the following areas: Supporting Clinical Teams, Health Information, Clinical Systems, Medical Assistant or Applications Analyst in a clinical and/or healthcare environment
  • Ability to analyze and interpret data
  • Problem solving skills
  • Proficient written and verbal communication skills. Ability to work in a multi-faceted, fast paced IT and business environment
  • Skilled in a variety of software applications and solid team and collaboration skills
  • Basic knowledge of medical and pharmacy terminology
  • Ability to demonstrate basic knowledge in medication therapeutic categories
  • Ability to identify generic name for brand name drugs and vice versa
  • Ability to demonstrate basic knowledge in understanding indication for medication

Preferred Qualifications:
  • 2+ years of directly related experience
  • Excellent organizational, interpersonal and decision-making skills
  • Ability to work in a relatively unsupervised environment with a high degree of accuracy
  • Ability to easily adapt to change in procedures and work processes

Physical Demands:
  • Rarely standing
  • Continuously sitting
  • Occasionally walking
  • Lifting light to 10 lbs


Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care 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)

OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare's support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords: Clinical Administrative Support, HIM, Health Information, Clinical Systems, Albuquerque, NM, New Mexico

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