Position Description:Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.Our customer service teams have a serious responsibility to make every contact informative, productive, positive, and memorable for what it says about how much we care.
Positions in this function includes those responsible for initial triage of members, administrative intake of members or managing the admission/discharge information post-notification, working with hospitals and the clinical team. Includes managing incoming calls, managing requests for services from providers/members, providing information on available network services and transferring members as appropriate to clinical staff. Manages the referrals process, processes incoming and outgoing referrals, and prior authorizations. This function includes intake, notification and census roles.
Primary Responsibilities:
Respond to incoming provider and enrollee calls
Resolve customer service inquiries which could include:
Enter notifications, Providers status of an existing notification and determining if notification is required.
Complete notification wizard along with ICD-9 and CPT coding
Provide excellent customer service to both providers and enrollees
Constantly meet established productivity, schedule adherence, and quality standards while maintaining good attendance.
Assist with faxes and emails
Experience preferred with processing UM requests. Skills with providing Public sector customer service.
Moderate work experience within own function.
Some work is completed without established procedures.
Basic tasks are completed without review by others.
Supervision/guidance is required for higher level tasks.
Qualifications:
Requirements:
High school education or equivalent experience.
2+ experience in an office setting using the telephone and computer as the primary instruments to perform the job duties.
6+ months professional experience do you have in clerical or administrator work.
6+ months Healthcare or Insurance Benefits experience.
6+ months with Medical Terminology experience.
2+ years experience using MS Office (Word, Excel, and Outlook)
Assets:
Call Center with high volume.
Hospital, physician, or medical clinical
Medicare and/or Medicaid
Facets or Macess experience.
OptumHealth is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.OptumHealth helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their health care needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.At OptumHealth, you will perform within an innovative culture that's focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that's greater than you've ever imagined.Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/VUnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
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