Associate Clinical Admin

This position is national remote, offering the flexibility to telecommute from anywhere within the U.S.

About the Role

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. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities.

Schedule

• Full-time, Monday - Friday
• Flexibility to work any 8-hour shift during normal business hours: 8:00 am - 5:00 pm EST
• Occasional overtime may be required
• 6 - 8 weeks of paid training, conducted virtually from 8:00 am - 5:00 pm EST, Monday - Friday

Responsibilities

• Manages the ancillary referral process by handling incoming and outgoing orders and prior authorizations
• Serves as the primary point of contact regarding referrals, engaging in telephonic and electronic client and vendor communications
• Follows protocols to determine patient eligibility and task requests appropriately
• Learns computer systems and navigates between applications and platforms to research information
• Determines whether authorizations are required for requested medical services
• References automated job aid tools to research relevant rules, regulations, or procedures
• Identifies and contacts appropriate resources to clarify information and respond to medical requests
• Schedules appointments and provides information regarding appointments and medical services to patients
• Orders supplies and durable medical equipment through the appropriate vendor
• Ensures orders are entered correctly for billing submission
• Productivity metrics:
  • Provisioners: 6 orders per day
  • Home Health Provisioners: 4 orders per day
  • Intake associates: 45 orders per day
• Makes 10-30 outbound calls per day and handles inbound calls

Requirements

• High School Diploma / GED or equivalent work experience
• Must be 18 years of age or older
• 1+ years of experience in an office, claims, or customer service environment
• Experience working in a metric-driven work environment
• Proficiency with Windows PC applications, including the ability to navigate and learn new and complex computer system applications

Preferred Qualifications

• Call center experience
• Durable Medical Equipment (DME) or Home Health (HH) knowledge/experience
• Experience working remotely
• Knowledge of ICD-10 and CPT codes

Telecommuting Requirements

• Ability to keep all company-sensitive documents secure
• Dedicated work area established, separated from other living areas, providing 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

Skills

• Ability to manage and prioritize multiple tasks in a challenging environment with focused diligence
• Excellent verbal and written communication skills
• Strong organizational skills
• Time management skills; ability to prioritize work and perform multi-tasks

Pay

The hourly pay for this role ranges from $16.00 to $29.00 per hour based on full-time employment, depending on factors including but not limited to local labor markets, education, work experience, and certifications.

Benefits

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