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. This position is full time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 4:30pm. It may be necessary, given the business need, to work occasional overtime. Employees are required to work some days onsite and some days from home. We offer 3 months of paid training. The hours during training will be 8:00am to 4:30pm, Monday - Friday.Training will be conducted onsite. If you are within commutable distance to the office at 440 Hopkinsville Street, Greenville, KY42345, you will have the flexibility to work from home and the office in this hybrid role* as you take on some tough challenges.Primary Responsibilities:
- Manage administrative intake of members
- 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
This is high volume, customer service environment. You'll need to be efficient, productive and thorough dealing with our members over the phone. You also must be able to work a flexible schedule that includes evening hours.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
- Must be 18 years of age OR older
- 2+ years of customer service experience
- Basic experience with Microsoft Word & Microsoft Excel
- Ability to train full time onsite for the first three months at 440 Hopkinsville Street, Greenville, KY 42345
- After training completes, ability to work every other week from home
- Ability to work Monday- Friday, 08:00AM - 04:30PM
Preferred Qualifications:
- Experience working within the health care Industry and with health care insurance
- Experience working with Microsoft Outlook (email and calendar management)
- Experience working in a hospital, physician's office or medical clinic setting
- Experience working in a call center
- A clerical or administrative support background
- Knowledge of ICD-9 and CPT codes
- RHIT or RHIA certification
Telecommuting Requirements:
- Reside within commutable distance to the office at 440 Hopkinsville Street, Greenville, KY 42345
- Ability to keep all company sensitive documents secure (if applicable)
- Required to have a dedicated work area established that is separated from other living areas and provides information privacy
- Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter PolicyAt 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.Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, 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.UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.#RPO