Description

This position is Remote in Pacific Standard Time zone. You will have the flexibility to work remotely* as you take on some tough challenges.

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

This position is full time. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 3:00 pm - 11:30 pm PST. This is a rotating evenings position to include holidays and alternating weekends. It may be necessary, given the business need, to work occasional overtime.

We offer 4 weeks of paid training. The hours during training will be 3:00 pm to 11:30 pm PST, Monday - Friday. Training will be conducted virtually from your home.

Primary Responsibilities:

• Consistently exhibits behavior and communication skills that demonstrate Optum's commitment to superior customer service, including quality, care and concern with each and every internal and external customer.
• Ensures proper input of inpatient and outpatient authorizations for acute care and skilled nursing facilities.
• Informs care managers of admission, eligibility and benefits issues.
• Enters, updates and close acute, observation, day surgery and SNF admission referrals within designated timeframes.
• Prints, sends mails or faxes or verbally provides authorizations / referrals to providers and facilities.
• Monitors fax queues for new admission notifications.
• Consistently and accurately completes data entry and documentation.
• Processes referrals for DME and coordinates home health services according to established policies, procedures, guidelines and timeframes.
• Redirects referrals to utilization management or medical director.
• Prioritizes and independently handles incoming referrals without supervision.
• Directs providers and patients to contracted provider networks and facilities and updates patient information as needed.
• Provides length of stay for exhaustion of SNF benefits.
• Arranges post discharge appointments.
• Facilitates exchange of information between all levels of care managers to ensure continuity of care.
• Performs high-level critical thinking for re-directing phone calls, referrals and other issues that may arise.
• Assists with answering telephones and maintaining files, logs or other reports.
• Acts as a resource for team members.
• Expected to participate in flexible weekday scheduling and weekend/ holiday coverage rotation per business needs.
• Seeks and identifies opportunities for process improvement.
• Meets or exceeds productivity targets.
• Uses, protects, and discloses Optum patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
• Performs additional duties as assigned.

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 OR equivalent work experience
• Must be 18 years of age OR older
• 1+ years of experience in a healthcare setting (doctor's office, medical Insurance provider or acute care setting)
• Experience with computers and Windows PC applications, which includes the ability to learn new and complex computer system application
• Knowledge of medical terminology
• Ability to work with multiple computer platforms simultaneously
• Ability to work full time. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 3:00 pm - 11:30 pm PST. This is a rotating evenings position to include holidays and alternating weekends. It may be necessary, given the business need, to work occasional overtime

Preferred Qualifications:

• Knowledge of CPT and ICD-10 coding
• Basic understanding of managed care principles

Telecommuting Requirements:

• Reside within Pacific Standard Time zone.
• 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 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.

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