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 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.This position is full-time, Wednesday - Saturday. Employees are required to have flexibility to work from 7:00 am - 6:00 pm CST 4 days, 10-hours per day. It may be necessary, given the business need, to work occasional overtime and weekends.We offer 4 weeks of paid training. The hours during training will be 8:00 am - 5:00 pm from Monday - FridayYou’ll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities:
Provides data entry, filing, tracking time frames and status of case files and mailing letters to patients and providers
Reviews denials and determines whether the decisions are retro/claims DOS or prospective DOS, and whether they are NCB or medically necessary
Monitors system approval queues and prints member letters, ensuring that all approvals are printed and mailed by end of business day
Prepares envelopes and letters for mailing according to the UM policy
Receives appeal requests from health plans and/ or QIO, logs request, researches and provides requested information
Works with claims department to redirect claims related appeal requests
Generates reports for analysis by department using the data entry system
Assists with CMS organization determination reports as needed
Must be able to work a flexible schedule that includes evening hours and holidays.
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
Must be 18 years of age OR older
2+ years of experience with working remote in data entry
Sound knowledge of medical terminology
Proficient software computer skills
Ability to work a 4-days a week, 10-hours per day, work week Wednesday - Saturday 7:00 am - 6:00 pm CST
Preferred Qualifications:
Related experience in healthcare
Telephonic and / OR telecommute experience
Familiarity with ICD-9 coding
Demonstrated excellent verbal and written skills
Proven ability to possess planning, organizing, conflict resolution, negotiation, and interpersonal skills
Independent problem identification / resolution and decision-making skills
Demonstrated ability to interact with individuals and with multidisciplinary teams
Ability to demonstrate excellent customer service with patients, providers, and health plan and interacting with other internal departments within the organization
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 California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C., Maryland Residents Only: The hourly range for this role is $16.54 to $32.55 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.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. 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 .#RPO