Description

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.

Schedule: Monday-Friday 8:00am to 4:30pm PST

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Ensuring a positive experience throughout the denial process while employing excellent customer service skills
• Facilitate communication between the hospital facilities, clinical teams, payers & billing
• Fulfilling payer requests for clinical reviews, secondary reviews to overturn denials
• Becoming knowledgeable of payer assigned time frames
• Understanding specific payer Utilization Management details
• Collaborating and alerting facility Case Managers of:
  • Additional payer needs
  • Requests for concurrent or retrospective review
  • Physician Advisor review
• Providing support in the denial process to ensure timely processing of denials followed by timely and accurate documentation
• Participating in denial management calls within RCM and with the facility solutioning for denial prevention and reduction
• Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Optum360's Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures to ensure adherence in a manner that reflects honest, ethical, and professional behavior
• Other duties as needed and assigned by their Manager, Director and or Senior

What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
• 401(k) Savings Plan, Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)

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 (or higher)
• 1+ years of experience in an Acute Care Facility or Centralized Business Office performing one of various functions including Billing/Coding, Balance after insurance or self-Pay Collections, Appeals processing, Patient Access Department Patient Scheduling, Pre-Service/Financial Clearance, Registration, Financial Counseling, or other functions related to revenue cycle activities in a complex multi-site environment
• Beginner level of proficiency in Microsoft Office including Word (creating and editing documents), Excel (creating and editing spreadsheets), and Outlook (creating, sending and saving email)
• Beginner level of proficiency with medical terminology
• Beginner level of proficiency with data entry and typing
• Must be comfortable using the internet to perform facility and payer research

Preferred Qualifications:

• Experience in hospital environment, doctors' office, or central billing office
• Experience working with insurance companies
• Thorough understanding of insurance benefits, policies, and procedures

Soft Skills:

• Must have effective verbal and written communication skills
• Must possess strong organizational skills
• Must be able to handle multiple priorities and projects simultaneously
• Must have excellent interpersonal and customer service skills
• Must be comfortable operating in a collaborative, shared leadership environment that encourages change engagement and participation, and open dialogue
• High sense of responsibility and accountability; Takes ownership and initiative
• Results-oriented with a focus on the end-goal and business results as the objective
• Ability to think and act; decisiveness, assertiveness, with ability to achieve results quickly
• Adaptable and flexible, with the ability to handle ambiguity and sometimes changing priorities
• Professional demeanor and positive attitude; customer service orientation
• Ability to learn, understands, and applies new technologies, methods, and processes
• Ability to be a self-starter and work independently and as a team to achieve a common goal
• Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Optum360 and our client organization(s)

*All Telecommuters 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 $16.15 to $28.80 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

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 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.

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.

#RPO #GREEN