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.
Positions in this function are responsible for checking in, completing new referral intake and onboarding, patient scheduling, answering billing questions and managing patient medical records for a clinic. Roles may vary based on the size of the clinic.
This position is full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00 AM - 8:00 PM EST. Our office is located at 20414 North 27th Ave, Suite #450, Phoenix, AZ, 85027.
We offer weeks of paid on-the-job training. New hires will complete 1-2 weeks of Optum new employee onboarding training and then the remainder of training will be done on the job during their normal scheduled shift.
Utilize Computer Systems to pull / verify / enter patient data:
Access insurance plan systems to verify insurance eligibility/benefits for patients and seek additional information as necessary
Input/update patient demographic data into computer system
Update/upload patient care data (e.g., care plan data, inpatient data, patient program flags) in computer systems
Document patient interactions in appropriate systems/logs (e.g., medication changes)
Enter/process patient referral data (e.g., medical services, radiology, durable medical equipment)
Generate reports on patient data through relevant computer systems/applications
Review/analyze patient data reports (e.g, discharges, hospital admissions/readmissions, skilled nursing facilities) and follow up as necessary
Identify inconsistencies in diagnosis/procedure codes and update codes in the system
Other duties as assigned
Prior Authorization:
Review and process all assigned Prior Authorization orders to completion
Obtain clinical information (including but not limited to medical history, diagnosis, and any relevant lab reports) necessary to complete the Prior Authorization
Diligently reviews the clinical information for completeness for insurance requirements and follows up with any questions
Follow the Prior Authorization Criteria for medications and submits requests
Communicate with insurance companies to pre-certify/authorize medications
Investigate outstanding medical documentation to ensure a patients account is not suspended
Assist with any denied claims to resolve potential mistakes by providing clinical information
Assist with medication change process by providing clinical information
Clearly support patient experience through patient-centered communications demonstrating excellent customer service skills
Assist with payer directed patients from receipt through scheduling while actively communicating with all stakeholders.
Perform duties and job functions in accordance with the policies and procedures established for the department
Recommend new approaches, policies, and procedures to influence continuous improvements in department's efficiency and services performed
Actively participate in problem identification and coordinates resolution between appropriate parties
Other duties as assigned
Organize / Schedule Patient Services / Appointments:
Verify referral approval prior to scheduling appointments
Schedule patients for walk-in or future appointments
Ask patient questions to verify patient data or needs for scheduling
Coordinate/confirm scheduling of doctor visits/services with patients
Identify resources available to support patient care (e.g., housing, social services, meals)
Maintain open communication and rapport with physicians to promote patient services/care
Ensures patient scheduling/follow up activities are completed according to federal, state, or organizational guidelines (e.g., referral guidelines, follow up notifications, PCP follow up)
Screens/forwards incoming calls from patients, physicians, and health plans
Other duties as assigned
Primary Responsabilities:
Greeting and checking-in patients as they arrive to our centers
Verifies patient insurance information upon check-in
Copies insurance cards and driver's license for all new patients
Collects patient paperwork and enters patient information into systems, ensuring patient information is accurate and up-to-date
Review and process all assigned Prior Authorization orders to completion
Schedule, reschedule, and follow-up with patients for necessary appointments via phone, text, and email
Manages patient cancellations
Answer calls within the center and market as appropriate
General center support i.e. light cleaning, supply ordering/stocking, etc.
Receiving packages and mail as appropriate
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
3+ years of healthcare customer service experience
1+ years of experience with benefit verification, prior authorization
Knowledge of ICD-9/10 and CPT codes
Understanding of health care insurance: deductibles, copays, coinsurance, out of pocket
Ability to work 40 hours per week
Ability to work any shift between the hours of 8:00 am - 8:00 pm EST, Monday - Friday
This position is full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00 AM - 8:00 PM EST. Our office is located at 20414 North 27th Ave, Suite #450, Phoenix, AZ, 85027
Soft Skills:
Knowledge of current authorization regulatory guidelines and requirements
Excellent organizational, consultative, analytical and problem-solving skills
Ability to work independently under general supervision and effectively prioritize workload
Ability to multitask and adapt to fast-paced work environment
Interpersonal skills
Ability to collaborate and communicate at all levels of an organization
Knowledge of basic medical terminology
Proficiency utilizing EHRs, Practice Management platforms and other software programs
Multitasking and time-management skills, with the ability to prioritize tasks
Ability to learn basic medical terminology
Ability to learn, read, and review insurance plan information and knowledge of insurance portals
Excellent customer service skills
Proactive and optimistic
Enjoy creating a friendly atmosphere
Good at coordinating with others to meet collective goals
Team player with ability to work in a fast-pasted environment
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.
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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.