Positions in this function are responsible for checking in, scheduling appointments, answering billing questions and managing patient medical records for a clinic. Roles may vary based on the size of the clinic(s).
- Generate letters for a member and provider when requests for service are denied
- Interpret the information contained in the authorization denial and complete the denial letter
- Select the correct denial letter dependent upon health plan and line of business requirements
- Be able to identify errors and ask questions to ensure the letter and decision meets regulatory requirements
- Meet established Turn Around Times based on regulatory requirements
- Moderate work experience within own function
- Some work is completed without established procedures
- Basic tasks are completed without review by others
- Supervision/guidance is required for higher level tasks
- High school education or equivalent experience
- Possess good writing skills
- Possess strong computer skills
- Be able to multi-task and complete work efficiently without compromising quality
- Work well under pressure
- Have a basic knowledge of medical terminology
- Healthcare experience highly preferred
What's the first thing that happens when one of the most successful physician groups in Orange County comes together with a global leader in health care? Opportunity. With Monarch HealthCare joining OptumCare and the UnitedHealth Group family of companies, people like you will find increasing levels of challenge, impact and professional success. With a vibrant network of hospitals and urgent care centers, we're changing health care for the better by improving access to affordable, high quality care, and working together to improve the patient experience. That takes passion, commitment, intense focus and the ability to contribute effectively in a highly collaborative team environment. Are you with us? Learn more about this exciting opportunity to do your life's best work.SM
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.
Job Keywords: prior authorizations, inpatient, insurance, Irvine, CA, healthcare, eligibility, United Health Group, Monarch