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 makes 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.
This position is full time (40 hours / week), Wednesday - Saturday. Employees are required to have flexibility to work any of our 10-hour shift schedules for 4 days during our normal business hours of 8:00 AM - 7:00 PM from Wednesday - Friday and 7:00 AM - 6:00 PM on Saturdays. It may be necessary, given the business need, to work occasional overtime and weekends.
We offer up to 4 weeks of paid training. The hours during training will be 8:00 AM - 5:00 PM from Monday - Friday.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities
- Provides data entry, filing, tracking time frames and status of case files, and mailing letters to patients and providers
- Reviews denials and determines whether the decisions are retro / claims DOS or prospective DOS, and whether they are NCB or medically necessary
- Monitors system approval queues and prints member letters, ensuring that all approvals are printed and mailed by end of business day
- Prepares envelopes and letters for mailing according to the UM policy
- Receives requests from health plans and / or QIO, logs request, researches, and provides requested information
- Works with the claims department to redirect claims related appeal requests
- Generate reports for analysis by department using the data entry system
- Assists with CMS organization determination reports as needed
- Must be able to work a flexible schedule that includes evening hours and holidays
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions 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 working remote in data entry experience
- Knowledge of medical terminology
- Proficient software computer skills
- Ability to work any of our 10-hour shift schedules for 4 days during our normal business hours of 8:00 AM - 7:00 PM from Wednesday - Friday and 7:00 AM - 6:00 PM on Saturdays. It may be necessary, given the business need, to work occasional overtime and weekends.
Preferred Qualifications
- Familiarity with ICD - 9 coding
- Related experience in healthcare
- Telephonic and / OR telecommute experience
- Verbal and written skills
- Independent problem identification / resolution and decision - making skills
- Ability to possess planning, organizing, conflict resolution, negotiation, and interpersonal skills
- Ability to interact with individuals and with multidisciplinary teams
- Ability to demonstrate customer service with patients, providers, and health plan and interacting with other internal departments within the organization
Telecommuting Requirements
- 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
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C., Maryland Residents Only: The hourly range for this role is $16.54 to $32.55 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to the volume of applicants.
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.
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