[Hiring] Per Diem Associate Patient Care Coordinator @UnitedHealth Group

Role Description

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.

Schedule: Monday-Friday 8:00am to 4:30pm PST

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Ensuring a positive experience throughout the denial process while employing excellent customer service skills
• Facilitate communication between the hospital facilities, clinical teams, payers & billing
• Fulfilling payer requests for clinical reviews, secondary reviews to overturn denials
• Becoming knowledgeable of payer assigned time frames
• Understanding specific payer Utilization Management details
• Collaborating and alerting facility Case Managers of:
  • Additional payer needs
  • Requests for concurrent or retrospective review
  • Physician Advisor review
• Providing support in the denial process to ensure timely processing of denials followed by timely and accurate documentation
• Participating in denial management calls within RCM and with the facility solutioning for denial prevention and reduction
• Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Optum360’s Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures to ensure adherence in a manner that reflects honest, ethical, and professional behavior
• Other duties as needed and assigned by their Manager, Director and or Senior

Qualifications

• High School Diploma/GED (or higher)
• 1+ years of experience in an Acute Care Facility or Centralized Business Office performing one of various functions including Billing/Coding, Balance after insurance or self-Pay Collections, Appeals processing, Patient Access Department Patient Scheduling, Pre-Service/Financial Clearance, Registration, Financial Counseling, or other functions related to revenue cycle activities in a complex multi-site environment
• Beginner level of proficiency in Microsoft Office including Word (creating and editing documents), Excel (creating and editing spreadsheets), and Outlook (creating, sending and saving email)
• Beginner level of proficiency with medical terminology
• Beginner level of proficiency with data entry and typing
• Must be comfortable using the internet to perform facility and payer research

Requirements

• Experience in hospital environment, doctors’ office, or central billing office
• Experience working with insurance companies
• Thorough understanding of insurance benefits, policies, and procedures

Benefits

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life & AD&D Insurance along with Short-term disability and Long-Term Disability coverage
• 401(k) Savings Plan, Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)