Med Allied – Navi – Makati City, NCR

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

Positions in this function includes those responsible for initial triage of members, administrative intake of members or managing the admission/discharge information post-notification, working with hospitals and the clinical team. Includes managing incoming calls, managing requests for services from providers/members, providing information on available network services and transferring members as appropriate to clinical staff. Manages the referrals process, processes incoming and outgoing referrals, and prior authorizations. This function includes intake, notification and census roles. *Employees in jobs labeled with ‘SCA’ must support a government Service Contract Act (SCA) agreement.

Primary Responsibilities:

• Manage the intake of members or the admission/discharge information post notification
• Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providers
• Manage the referral process, processing incoming and outgoing referrals and prior authorizations, including intake, notification and census roles
• Provide appropriate triage and care coordination notification cases for non-clinical assessment/intervention
• Handle resolution/inquiries from members and/or providers
• Works on simple tasks using established procedures
• Depends on others for guidance
• Work is typically reviewed by others
• 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

This is high volume, customer service environment. You’ll need to be efficient, productive and thorough dealing with our members over the phone. You also must be able to work a flexible schedule that includes evening hours.

Required Qualifications:

• HS Diploma or GED
• 1+ year of customer service experience analyzing and solving customer problems
• Limited work experience
• Ability to create, edit, save and send documents utilizing Microsoft Word and Excel
• Ability to type and talk at the same time and navigate through multiple screens

Preferred Qualifications:

• Experience working within the health care Industry and with health care insurance
• Experience working with Medicare and/or Medicaid Services
• Call center experience
• Experience working in a metric-driven work environment
• A clerical or administrative support background
• Knowledge of ICD-9 and CPT codes

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: Optum is an Equal Employment Opportunity 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.

Optum is a drug-free workplace. © 2025 Optum Global Solutions (Philippines) Inc. All rights reserved.