Clinical Administrative Coordinator

United Health Group -  - Responsibilities:
Manage the internal/external referral process and daily referral reconciliation gathering required information and documents needed, working them accordingly in compliance with established timelines;
Manage administrative intake of members;
Maintains department records as requested by supervisor, department director and/or other regulatory agencies;
Receives all requests for exam (CD) - check out; processes requests and prepares CD check-out requests according to protocol;
Receives and processes in the RIS all outside facility in-coming exams; down-load all outside facility exams in PACS;
Prepares and processes all outside facility exams for return to facility or patient;
Processes in all returned exams;
Maintains CD files and purges outdated exams;
Requests pertinent prior exams for all modalities per protocol;
Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providers;
Process incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles;
Assist the clinical staff with setting up documents/triage cases for Clinical Coverage Review;
Handle resolution/inquiries from members and/or providers