Specialty Navigator I

About the role

HYBRID IN NORWOOD, MA
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.

Responsibilities

• Manage the referral process, processing incoming and outgoing referrals and prior authorizations, including intake, notification and census roles
• Handle resolution/inquiries from members and/or providers
• Answers and replies to a large volume of telephone calls, faxes and internet queries, utilizing and adhering to department scripts and guidelines
• Reviews patient record. If referral does not already exist, obtain authorization from payer, enter information into EPIC. Forwards authorization to specialist's office
• Keeps patient and facility informed of status, referrals, updates and process
• Obtains authorizations from payer websites efficiently and effectively. Keeps log in and credentials
• Researches questions and concerns from patients; assists in resolving any issues as they relate to the referral process
• Escalates difficult issues, problems, etc., to higher level coordinators or supervisory staff
• Works with team to ensure timely process of referrals. Participates in team problem solving activities, focusing on production and quality

Qualifications

• High School Diploma/GED
• 1+ years of customer service experience, preferably in a healthcare setting
• Intermediate level proficiency with creating, editing, saving and sending documents utilizing Microsoft Word and Excel
• Intermediate level of proficiency with typing and talking at the same time and navigating through multiple screens

Skills

• Independence of Action
• Knowledge

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.)

Pay

The hourly pay for this role will range from $16.00 to $29.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Schedule

FT, 40 hours. Monday - Friday,8:30am - 5pm. Hybrid schedule to be determined by manager upon hire.

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution