Position 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.
Part of the challenge here is dealing positively with members and providers in sometimes challenging circumstances. As a subject matter expert, you'll also be the go-to resource for information.
- Primary point of contact for providers or members regarding medical/behavioral/clinical services or benefits.
- Extract Extract and review fax requests for medical or clinical Services.
- Receive calls requesting medical/behavioral/clinical services.
- Receive electronic referral form requests for medical/behavioral/clinical services.
- Utilize phone system to respond to and transfer calls to appropriate individuals.
- Ask callers standard questions to understand requests, gather necessary information, and assess urgency.
- High School Diploma/GED or equivalent experience
- 1+ years experience working in an office setting using telephone and computer as the primary function to preform job duties
- Experience using a computer and Microsoft Office Word (create, edit, save) Excel (create, edit, save) Outlook (send, receive, set appointments)
- Ability to maintain confidentiality and adhere to HIPAA requirements
- Ability to work 8AM - 5PM M-F and have the flexibility to work evening hours
- Experience working with health care insurance
- Experience in a hospital, physician's office or medical clinic setting
- Clerical or administrative support background or experience working in a call center environment
- Experience working with long-term care and Medicare and/or Medicaid Services
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: 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.
Keywords: Administrative, UnitedHealth, Optum, Insurance, Call Center, Medicare, Medicaid, Wauwatosa