Like you, Optum, part of the UnitedHealth Group family of businesses, is strong on innovation. And like you, we'll go the distance to deliver high-quality care. As part of our clinical support team, you will be a key component in customer satisfaction and have a responsibility to make every contact informative, productive and positive for our members and providers. You'll have the opportunity to do live outreach, educating members about program benefits and services while also helping to manage member cases. Bring your skills and talents to a role where you'll have a chance to make an impact.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. Work is typically reviewed by others.
Primary Responsibilities:
Manage the intake of members or the admission/discharge information post notification
Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providers
Manage the referral process, processing incoming and outgoing referrals and prior authorizations, including intake, notification and census roles
Provide appropriate triage and care coordination notification cases for non-clinical assessment/intervention
Handle resolution/inquiries from members and/or providers
Work on simple tasks using established procedures
Depend on others for guidanceThis 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.Required Qualifications:
1+ year/s of customer service experience analyzing and solving customer problems
Ability to create, edit, save and send documents utilizing Microsoft Word and Excel
Ability to type and talk at the same time and navigate through multiple screens
Preferred Qualifications:Experience working within the health care Industry and with health care insurance
Experience working with Medicare and/or Medicaid Services
Experience working in a metric-driven work environment
Call center experience
Clerical or administrative support background
Knowledge of ICD-9 and CPT codeReady to answer the call? Take this opportunity to do your life's best work.(sm)
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)Diversity creates a healthier atmosphere: Optum is an Equal Employment Opportunity 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.Optum is a drug-free workplace. © 2019 Optum Global Solutions (Philippines) Inc. All rights reserved.
