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 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. *Employees in jobs labeled with 'SCA' must support a government Service Contract Act (SCA) agreement.
This position is full time, Monday - Friday. Employees are required to have flexibility to work our normal business hours of 8:00am - 5:00pm. It may be necessary, given the business need, to work occasional overtime. Our office is located at 208 CRYSTAL GROVE BLVD Lutz FL 33548.
We offer 2 weeks of on-the-job training. The hours of the training will be aligned with your schedule.
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
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
Experience with Microsoft Word, Excel and Outlook
Ability to work our normal business hours of 8:00am - 5:00pm. It may be necessary, given the business need, to work occasional overtime.
Preferred Qualifications:
Experience working within the health care Industry and with health care insurance
Experience working in a hospital, physician's office or medical clinic setting
Clerical or administrative support background
Knowledge of ICD-9 and CPT codes
Experience working in a call center
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.
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.