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Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm)
Like you, UnitedHealth Group is solid on innovation. And like you, we'll go the distance to deliver high-quality care. As part of our clinical support team, you will be a key component in customer satisfaction and have a responsibility to make every contact informative, productive and positive for our members and providers. You'll have the opportunity to do live outreach, educating members about program benefits and services while also helping to manage member cases. Bring your skills and talents to a role where you'll have a chance to make an impact.
You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Work Schedules include:
Wednesday-Saturday 7AM-6PM (Central Time)
Wednesday-Saturday 8AM-7PM (Central Time)
Sunday-Wednesday 7AM-6PM (Central Time)
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.
High school diploma or GED equivalent
2+ years of related experience
Sound knowledge of medical terminology
Proficient software computer skills
Ability to work Wednesday through Friday from 10am-7pm, Saturday and Sunday for 8am-5pm CST
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
Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 550,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)
WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.
Colorado, Connecticut, Nevada, or New York City Residents Only : The hourly range for Colorado residents is $16.00 to $26.88. The hourly range for Connecticut/Nevada/New York City residents is $16.83 to $29.66. 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 incentives.
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: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
UnitedHealth Group provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
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