Vacancy expired!
You’ll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work. SMFirst point of contact for medical management activities. Receive inquiries regarding prior authorization, notification, peer to peer requests, and status requests. Determine requirements for authorization / notification and create a case in the applicable documentation system and complete administrative approvals.This position is full - time. Employees are required to work our normal business hours of 8:00 AM - 5:00 PM MST (Mountain Standard Time zone) including the flexibility to work occasional overtime and outside standard hours of operations based on changing business needs.We offer 2 weeks of training. Training will be conducted virtually from your home.All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.Primary Responsibilities:Respond to Incoming Provider and Enrollee calls
Resolve Customer Service inquiries
Provide excellent Customer Service to both Providers and Enrollees
Constantly meet established productivity, schedule adherence, and quality standards while
maintaining good attendance.
Receives Care Coordination notification cases for non-clinical assessment / intervention and
provides appropriate triage
Processes out of network requests for consideration of in network level of benefits for physician
specialty referrals for appropriate products
Processes notification requirements for outpatient procedures, home health, DME, transition of
care, and network gap issues
Determines benefit coverage issues based on employer group contracts
Sets up / documents / triages cases for (CCR) Clinical Coverage Review
Ensures all potential member needs are identified and forwarded to the appropriate Care
Coordinator for risk validation when applicable
Processes letters within DOL time frames
Verifies appropriate ICD - 10 and CPT coding usage
Communicates to providers and members benefit determinations within DOL time frames
Assist with faxes and emails
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
Other duties as assigned by manager and / or director
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 higher)
1+ years of professional experience in a medical office / customer service environment
Proficiency in Microsoft Word (create, edit, save, and send documents)
Proficiency in Microsoft Excel (create, edit, save, and send documents)
Computer proficiency including, but not limited to, ability to learn new computer system applications
Ability to work any 8-hour shift between the hours of 8:00 AM - 5:00 PM MST (Mountain Standard Time zone) including the flexibility to work occasional overtime and outside standard hours of operations based on changing business needs
Preferred Qualifications:Bachelor's Degree (or higher)
2+ years of professional experience in an Office setting, using the telephone and computer as the primary instruments to perform the job duties OR 2+ years of Customer Service experience
Knowledge of Medical terminology
Experience with working within the Healthcare Industry, Hospital, Physician's Office, OR Medical Clinical setting, Medical Terminology, ICD - 9 and CPT codes, Medicare and / OR Medicaid Services, Call center experience
Professional experience in a Clerical OR Administrative support related role
Reside within an MST (Mountain Standard Time zone) location
Telecommuting Requirements:Required to have a dedicated work area established that is separated from other living areas and provides information privacy
Ability to keep all company sensitive documents secure (if applicable)
Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
Soft Skills:Ability to multi - task
Excellent oral and written communication skills
Ability to work in a fast - paced, dynamic, rapidly changing environment
Strong aptitude for working in a production driven environment
Must be a self-starter and able to work autonomously
Analyzing and solving customer problems
UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at https://uhg.hr/transitioning-militaryLearn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible. https://uhg.hr/vetCareers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 5 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near - obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, Military families and Veterans wherever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life’s best work. SMColorado, Connecticut or Nevada Residents Only : The salary range for Colorado residents is $18.17 - $32.26. The salary range for Connecticut / Nevada residents is $20.00 - $35.53. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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 incentivesDiversity 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: #RPO, #YELLOW
Vacancy expired!