Job Description

This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
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.
This role supports the state mandated Verbal Notice for clinical decisions for members, including initial triage, administrative intake, and post-notification management of admission/discharge information. The position involves contact with hospitals, providers, and clinical teams to ensure timely and accurate service delivery. Responsibilities include making verbal notice outbound calls, managing voicemail, expedited requests, or authorizations. (100% outbound call center)
This position is full-time, Monday - Sunday. Employees are required to work an 8 hour shift during our normal business hours of 8:00am - 8:00pm EST, including holidays. It may be necessary, given the business need, to work occasional overtime.
We offer 2 weeks of paid training. The hours of training will be based on your schedule or will be discussed on your first day of employment.
Primary Responsibilities:

• Perform outbound calls to hospitals, clinics, facilities, and the clinical team to manage approvals for members and providers.
• Perform outbound calls to hospitals, clinics, facilities, and the clinical team to manage denials in areas such as Oncology and radiology.
• Resolve inquiries and provide support to members and providers
• Maintain efficiency, productivity, and thoroughness in a fast-paced, customer service-driven environment.
• Review documentation from clinical staff regarding decisions.
• Perform outbound call requests from clinical staff to members and providers.
• Conduct provider & member notifications on decisions.
• Provide information on network services and transfer members to clinical staff as needed.
• Maintain accurate documentation and follow compliance protocols.

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction 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 equivalent work experience
• Must be 18 years of age OR older
• 2+ years of customer service experience, including analyzing and solving customer problems
• Intermediate experience with any or all Microsoft Word, Excel, and Outlook, Smart Sheets, Power Point, Teams.
• Experience utilizing multiple systems/platforms across multiple screens while on a call
• Ability to work an 8-hour shift during our normal business hours of 7 days a week 8:00am - 8:00pm EST, including holidays. It may be necessary, given the business need, to work occasional overtime.

Preferred Qualifications:

• Experience working with health care insurance, including Medicare and/or Medicaid Services
• Experience in a hospital, physician's office, or medical clinic setting
• Clerical or administrative support background
• Experience working in a call center environment
• Ability to troubleshoot occasional internet connection problems and PC issues with guidance

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
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 $17.74 - $31.63 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.
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.

Skills Required