Pre Authorization Representative

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. 

Position in this function is responsible for completing the financial clearance process and creating the first impression of Optum services to patients, their families, and other external customers.  Work in a team environment with medical staff, nursing, ancillary departments, insurance payers, and other external sources to assist families in obtaining healthcare and financial services.

Primary Responsibilities:

• Review and analyze patient visit information to determine whether authorization is needed and understands payor specific criteria to appropriately secure authorization and clear the account prior to service where possible
• Ensure that initial and all subsequent authorizations are obtained in a timely manner
• May provide mentoring to less experienced team members on all aspects of the revenue cycle, payer issues, policy issues, or anything that impacts their role
• Meet and maintain department productivity and quality expectations
• Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so

Required Qualifications:

• Must be 18 years or older
• High School Diploma or GED OR Equivalent Experience
• Previous customer service experience in an office setting or professional work environment
• Experience with Microsoft Office Products

Preferred Qualifications:

• Associate or Vocational degree in Business Administration, Health Care Administration, Public Health, or Related Field of Study
• Experience with insurance and benefit verification, Pre-Registration and/or Prior Authorization activities in healthcare business/office setting
• Experience working with clinical staff
• Experience working with clinical documentation
• Experience working with a patients clinical medical record

Soft Skills:

• Excellent customer service skills
• Excellent written and verbal communication skills
• Demonstrated ability to work in fast paced environments

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.