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

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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00am - 6:30pm CST. It may be necessary, given the business need, to work occasional overtime and/or weekends.

We offer 12 weeks of training. Training will be conducted virtually from your home.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary Responsibilities:

• Review and triage incoming faxes for dedicated lines of business on behalf of clinical staff.
• Gather and data enter clinical specifics to build authorization for clinicians.
• Process administrative authorization requests submitted both electronically and paper within compliance timeframes, in various clinical platforms.
• Serves as a liaison between call and clinical operation to investigate and resolve authorization conflicts that are submitted by claim processors.
• Administratively assign Treatment Milestone Outlier (TMO) Authorizations to Facility Based Care Advocates (FBCA)
• Outbound calls to providers of service to withdrawal and/or update authorizations.
• Outbound member notification calls within defined regulatory timeframes.
• Outbound calling to providers of service to obtain consumers treatment status as a part of the access to care process.
• Generate written approval notification letters using ELGS (Electronic Letter Generation System)
• Manually fax authorization letters to provider for members at IP facilities to ensure regulated written notification timeframes are met.
• Process various non-clinical admin tasks in support of clinical operations.
• Front-end eAccommodation submission.
• Navigate and document multiple clinical applications and SharePoint sites
• Submit Electronic Provider Updates requests.
• Support internal business partner emailed inquires.
• Enter services that they are requesting into the system
• Must have accurate documentation
• Must meet monthly metrics

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.

Required Qualifications:

• High School Diploma / GED (or higher)
• 2+ years of customer service experience in a call center environment
• 2+ years of business office or administrative assistant experience supporting a team
• Experience working with a PC and windows applications, with the ability to learn other sometimes complex systems
• Experience using Microsoft office system products (Outlook, Word, Excel, Teams)
• Ability to type at least 40 WPM
• Ability to work any 8-hour shift between 7:00 am – 6:30 pm CST

Preferred Qualifications:

• 1+ years of experience working with ICD-9 / 10 and CPT codes
• Professional experience in a clerical or administrative support related role
• Any experience working within the healthcare industry
• Experience in a clinical environment
• Experience applying specific policies or standards to daily work to assure compliance with relevant regulations.
• Working knowledge of medical terminology
• Microsoft SharePoint experience
• Experience in healthcare benefits
• Familiar with and understanding of Medicare compliance and regulatory guidelines
• Familiar with the clinical and claims platforms (Linx, ICUE, Cosmos, UNET, OHBS Facets) needed to perform administrative tasks as well as problem solve requests
• Understanding of fundamental health-care related terminology, programs or services

Telecommuting Requirements:

• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Ability to keep all company sensitive documents secure (if applicable)
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

Soft Skills:

• Ability to interact courteously and professionally with colleagues, internal and external business partners

Careers with Optum . Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

California, Colorado, Connecticut, Nevada, Washington or New York, Rhode Island Residents Only: The salary range for California / Colorado / Connecticut / Nevada / Washington / New York / Rhode Island residents is $16.00 - $31.44.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: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer 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.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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