Optum

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. Join us to start Caring. Connecting. Growing together.

Are you looking for a chance to get your foot in the door with a great company? You’ve found it here. Already one of the world’s leading health care companies, Optum, part of the UnitedHealth Group family of businesses, is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. Here, you’re not just working. You are making great things happen for the people who rely on us for healthcare across the United States. You’re part of an elite team that is equipped with the best tools and resources, the most thorough training and learning opportunities and a mission that can inspire you every day.

This employee will be part of the Intake Operations team covering areas of concurrent intake, appeals intake, and support services, based on business needs. As a Case Coordinator, this individual will be trained in all three areas, staying current on any changes in process, and assist in each area as directed. This individual will be responsible for gathering data and processing information sent from client hospitals to OPAS as documents, image files, and other channels and will manage their safe keeping and entry into OPAS’s internal database. The individual in this role will also track and verify the quality of this data in a timely manner, taking action when appropriate to ensure that the data is accurate and complete.

Work Schedule: This position is full-time (40 hours/week) as assigned, with a weekend requirement including Holidays. It may be necessary, given the business need to work overtime. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 6:00am – 12:00am AST. (Several shifts available)

Primary Responsibilities:

• Enter demographic and clinical data into the clinical database for both concurrent intake and appeals intake, as assigned
• Electronically access client clinical systems to obtain data as well as enter case recommendations into the client system, assisting with document retrieval and troubleshooting from client/vendor systems as needed
• Documentation, preparation, data entry, indexing, and quality control of documents related to retrospective appeals intake
• Assist in placing telephonic calls to provide case updates and/ or recommendations to clients and payors
• Maintain the integrity, accuracy, and organization of retrospective and concurrent related documents
• Communicate with the concurrent and retrospective teams, vendors, and the OPAS application support teams as needed
• Monitor daily workflow for changing priorities, maintaining flexibility with responsibilities and hours, multi-tasking if needed
• Perform other related duties as assigned
• ENGLISH PROFICIENT ASSESSMENT WILL BE REQUIRED AFTER APPLICATION ***

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 or higher degree
• 1+ years of experience with medical record management or medical billing (healthcare information)
• Proven knowledge of office procedures and methods including telephone communications, office systems (Outlook, Excel, Word), and record keeping
• Bilingual proficiency both Spanish and English
• Available to work full-time (40 hours/week) as assigned, with a weekend requirement including Holidays. It may be necessary, given the business need to work overtime. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 6:00am – 12:00am AST. (Several shifts available)

Preferred Qualifications:

• Demonstrated understanding of confidentiality and HIPAA compliance
• Proven knowledge of insurance appeal processes
• Demonstrated computer and typing skills as well as prior knowledge and use of portals, websites, and download data files

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.