Description

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.

The Insurance Verification Specialist is responsible for serving as a liaison between insurance payers, patients and providers to ensure coverage eligibility and authorizations are accurately documented in a patient's record for hospital services.

Primary Responsibilities:

Verify Insurance eligibility/benefits and verify/obtain authorizations in at least 2 of the following:

• Routine and urgent imaging exams and procedures
• Surgical Procedures
• Cardiology Testing and procedures
• Adult and Pediatric outpatient rehabilitation
• Outpatient Infusions
• Notifications of Admission

Knowledge of Insurance authorization process including, but not limited to:

• Which exams/procedures require prior authorization
• Understand clinical information needed to initiate an authorization
• Navigate payer portals and appropriately document reference numbers when initiating authorization or checking for status updates
• Accurately verify insurance coverage and eligibility for patients
• Appropriate notation of accounts to keep registration and scheduling informed on authorization status
• Warm transfer patients to correct scheduling areas if authorization is not obtained

Resource to providers, patients and modalities through:

• Appropriately refer questions to clinical areas for clarification
• Provide authorization status updates and cost estimates

Keep up to date with hospital and Optum policies and procedures

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions 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
• 1+ years of experience working within the medical field
• 1+ years of experience working with CPT Codes and ICD10 Codes

Preferred Qualifications

• Basic understanding of medical terminology and anatomy
• Experience in Hospital Revenue Cycle (Scheduling, Registration, Authorization, Billing, etc.)
• Epic Experience

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.98 to $32.12 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

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

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