Job Details

Remote Clinical Support Team MemberOptum 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 make 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.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.This position is full-time, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00 am - 7:00 pm local time. It may be necessary, given the business need, to work occasional overtime or weekends.We offer 3 - 4 weeks of training. The hours during training will be 8:00 am - 5:00 pm CST, Monday - Friday.Primary Responsibilities:Manage administrative intake of membersWork with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providersAssist the clinical staff with setting up documents/triage cases for Clinical Coverage ReviewHandle resolution/inquiries from members and/or providerYou'll need to be efficient, productive and thorough dealing with our providers over the phone. You also must be able to work a flexible schedule that includes evening hours.Required Qualifications:High School Diploma / GEDMust be 18 years of age OR older2+ years of customer service experienceExperience working within the health care Industry and with health care insuranceExperience with Microsoft Word, Microsoft Excel and Microsoft OutlookAbility to work full-time, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00 am - 7:00 pm local time. It may be necessary, given the business need, to work occasional overtime or weekendsPreferred Qualifications:Experience with Prior Authorization and Benefit VerificationClerical OR administrative support backgroundKnowledge of ICD-10 and CPT codesTelecommuting 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 (UHG requires a wired internet connection: cable, DSL or fiber internet service with Minimum speed standard of 25 Mb download/10-15 Mb upload. Wireless services such as satellite, hot spot, line of sight antenna cannot be used for telecommuting.)*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter PolicyPay 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 $20.00 to $36.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.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.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.