Clinical Operations Coordinator

Position Overview

The Clinical Operations Coordinator supports the daily operations of an insurance-based primary care practice, ensuring efficient patient flow, accurate insurance processing, and strong coordination between providers, patients, and administrative teams. This role is critical in maintaining compliance, optimizing revenue cycle processes, and delivering a seamless patient experience.

Key Responsibilities

Patient & Front Office Coordination

• Manage patient scheduling, intake, and follow-ups for primary care services
• Verify insurance eligibility, benefits, and prior authorizations before appointments
• Ensure accurate patient registration, demographics, and documentation
• Serve as the primary point of contact for patient inquiries, concerns, and escalations

Insurance & Revenue Cycle Support

• Verify coverage, co-pays, deductibles, and referral requirements
• Coordinate prior authorizations for labs, imaging, medications, and specialty referrals
• Work closely with billing teams to resolve claim denials, rejections, and discrepancies
• Ensure accurate coding support (ICD-10, CPT awareness—not coding, but coordination)
• Track and follow up on outstanding claims, referrals, and authorizations

Clinical Coordination

• Support providers with daily schedules, patient flow, and documentation completion
• Coordinate referrals to specialists and ensure closed-loop communication
• Assist with lab/imaging orders and results tracking
• Ensure timely completion of charting and compliance-related documentation

Compliance & Quality

• Maintain adherence to HIPAA and payer-specific requirements
• Support quality initiatives (HEDIS measures, preventive care tracking, gap closure)
• Assist with audits, chart reviews, and compliance reporting
• Maintain up-to-date provider credentialing and payer enrollment records

Operational & Administrative Support

• Track KPIs such as patient volume, no-show rates, authorization turnaround times
• Identify workflow inefficiencies and recommend process improvements
• Assist with EMR management (Athena, eClinicalWorks, etc.)
• Coordinate communication between front office, clinical staff, and billing

Qualifications

• 2+ years of experience in a primary care, outpatient clinic, or healthcare setting
• Strong understanding of insurance workflows (PPO, HMO, Medicare, Medicaid)
• Experience with prior authorizations, referrals, and eligibility verification
• Familiarity with EMR systems (Athenahealth preferred)
• Knowledge of revenue cycle processes (front-end and back-end coordination)
• Excellent communication, organization, and problem-solving skills

Preferred Experience

• Experience in high-volume primary care or multi-provider clinics
• Familiarity with value-based care models (HEDIS, risk adjustment, RAF scoring)
• Experience handling denied claims and payer follow-ups
• Bilingual (highly preferred depending on patient population)

Key Competencies

• Detail-oriented with strong follow-through
• Ability to multitask in a fast-paced clinic environment
• Strong patient service mindset
• Critical thinking and proactive problem-solving
• High accountability and ownership

Pay: $23.00 - $28.00 per hour

Benefits:

• Dental insurance
• Health insurance
• Paid time off

Work Location: Hybrid remote in Los Angeles, CA 90048