You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Energize your career with one of Healthcare’s fastest growing companies.
You dream of a great career with a great company – where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it’s a dream that definitely can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.
This opportunity is with one of our most exciting business areas: Optum – a growing part of our family of companies that make UnitedHealth Group a Fortune 10 leader.
Optum 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 healthcare 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.
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 - 5:00pm). It may be necessary, given the business need, to work occasional overtime.
We offer 8 weeks of paid training. The hours during training will be 8:00am to 5:00pm, Monday - Friday. Training will be conducted virtually from your home.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
- Receive cases regarding prior authorization, and or notification
- Complete administrative approvals and prep cases for RN/RMD review with DOL time frames
- Respond to incoming provider and enrollee calls
- Determine if the consumers are eligible for a health program
- Take calls from providers and enter services that they are requesting into the system
- Must have accurate documentation and strong attention to detail
- Must meet weekly metrics
- Provide excellent Customer Service to both Providers and Enrollees.
- Constantly meet established productivity, schedule adherence, and quality standards while maintaining good attendance.
- Receives Care Coordination notification cases for non-clinical assessment/intervention and provides appropriate triage
- Processes out of network requests for consideration of in network level of benefits for physician specialty referrals for appropriate products
- Processes notification requirements for outpatient procedures, home health, DME, and, network gap issues
- Determines benefit coverage issues based on employer group contracts
- Sets up/documents/triages cases for (CCR) Clinical Review
- Processes letters within DOL time frames
- Verifies appropriate ICD-10 and CPT coding usage
- Communicates to providers and members benefit determinations within DOL time frames
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.
- High School Diploma / GED.(or higher)
- Must be able to work Monday- Friday 8:00am-5:00pm
- 1+ years of experience working in the healthcare industry
- 2+ year of customer service experience analyzing and solving customer problems or experience in a call center environment
- 1+ year of experience with medical terminology(Default)
- 2+ years’ experience working with Microsoft Word (creating, editing, saving documents) and Microsoft Excel (creating, editing, saving spreadsheets)
- 2+ years’ experience working with a PC and windows applications, with the ability to learn other sometimes complex systems
- Required to have a dedicated work area established that is separated from other living areas and provides information privacy
- Ability to keep all company sensitive documents secure (if applicable)
- Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
- 2+ years of professional experience in an Office setting using the telephone and computer as the primary instruments to perform the job duties.
- Experience working within the Healthcare Industry, Hospital, Physician's Office, or Medical Clinical setting, Medical Terminology, ICD-9 and CPT codes, Medicare and/or Medicaid Services or in a call center environment.
- Ability to remain focused and productive each day though tasks may be repetitive
- Capable of working in a complex, fast paced, dynamic environment that involves multiple customer types, products and evolving systems
- Ability to work autonomously - must be a self – starter
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health - related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.SM
Colorado Residents Only: The hourly range for Colorado residents is $15.00 to $25.19. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.
Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at https://uhg.hr/transitioning-military
Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible. https://uhg.hr/vet
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.
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