Manages member and provider referral intake, admission and discharge information, service requests, and incoming and outgoing cases. Coordinates with hospitals, clinics, facilities, and clinical teams while performing non-clinical triage, outreach, submissions, notifications, and issue resolution. The role operates in a high-volume customer service environment and requires knowledge of medical coding, insurance-related care coordination, and referral processing.
Requisition Number: 2382654
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
Schedule: This position is full-time, Monday - Friday. Employees are required to work during our normal business hours of 8:00am - 5:00pm; Occasional evening coverage may be required.
This is high volume, customer service environment. You'll need to be efficient, productive and thorough in dealing with our members over the phone. You also must be able to occasionally work a flexible schedule that may include evening hours/weekends as business needs.
If you reside in California, you'll enjoy the flexibility to telecommute* as you take on some tough challenges.
Primary Responsibilities:
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:
Preferred Qualifications:
All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $16.00 to $29.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
#RPO #GREEN
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
Schedule: This position is full-time, Monday - Friday. Employees are required to work during our normal business hours of 8:00am - 5:00pm; Occasional evening coverage may be required.
This is high volume, customer service environment. You'll need to be efficient, productive and thorough in dealing with our members over the phone. You also must be able to occasionally work a flexible schedule that may include evening hours/weekends as business needs.
If you reside in California, you'll enjoy the flexibility to telecommute* as you take on some tough challenges.
Primary Responsibilities:
- Manage the intake of members or the admission/discharge information post notification
- Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providers
- Manage the referral process, processing incoming and outgoing cases, including intake, notification etc.
- Provide appropriate Triage, Outreach, Submission and other process steps for non-clinical process
- Handle resolution/inquiries from members and/or providers
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/GED
- 1+ years of customer service experience analyzing and solving customer problems
- 1+ years of experience processing medical referrals, authorizations, or insurance related (non-clinical) care coordination
- Basic level of proficiency with Microsoft Office
- Working knowledge with ICD 9/10 and CPT codes
Preferred Qualifications:
- Experience working within the health care Industry and with health care insurance
- Experience working with Medicare and/or Medicaid Services
- Experience with customer outreach in a call center, as a medical assistant, or similar
- Clerical or administrative support background
- Strong communication, problem-solving, and de-escalation skills
- Ability to manage multiple work queues and prioritize tasks in a fast-paced, high-volume environment
- Bilingual fluency in English and Spanish (verbal and written)
All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $16.00 to $29.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
#RPO #GREEN
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