[Hiring] Financial Clearance Representative Associate @UnitedHealth Group

Role Description

Responsible for completing the financial clearance process and creating the first impression of Optum services to patients, their families, and other external customers. You will articulate information in a manner that patients, guarantors, and family members understand and will know what to expect regarding their financial responsibilities. Work with medical staff, nursing, ancillary departments, insurance payers, and other external sources to assist families in obtaining healthcare and financial services.

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

Primary Responsibilities:

• Verify insurance eligibility and complete automated insurance eligibility verification, when applicable, and appropriately document information in Epic.
• Confirm that a patient’s health insurance(s) is active and covers the patient’s medication.
• Review and analyze patient visit information to determine whether authorization is needed and understand payor specific criteria to appropriately secure authorization and clear the account prior to service where possible.
• Ensure that initial and all subsequent authorizations are obtained in a timely manner.
• May provide mentoring to less experienced team members on all aspects of the revenue cycle, payer issues, policy issues, or anything that impacts their role.
• Initiate prior authorizations for medications.

Qualifications

• High School Diploma/GED (or higher)
• 6+ months of experience with insurance and pharmacy benefit verification, pre-experience with prior authorization activities in healthcare business office/insurance operations
• 6+ months of experience using basic retail medication knowledge
• Intermediate level of proficiency with Microsoft Office products
• Must be 18 years of age OR older

Requirements

• Associate degree or Vocational degree in Business Administration, Health Care Administration, Public Health, or Related Field of Study (preferred)
• Experience working with clinical staff (preferred)
• Previous experience working in outpatient and/or inpatient healthcare settings (preferred)
• Experience working in clinical documentation (preferred)
• Previous experience working with a patient’s clinical medical record (preferred)
• Retail pharmacy experience (preferred)
• EPIC experience (preferred)
• Payer portals and/or covermymeds experience (preferred)
• CphT or CMA certification (preferred)

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution (all benefits are subject to eligibility requirements)