Position Description:

This is a call center environment however mainly outbound engaging with members within the Disease Management program to encourage them to for enrollment into the program.  This is not cold calling, these are members who qualify for the program that you will be reaching out to in order to engage with them and explain the program benefits.  If the members are interested, you will schedule a time for them to speak with one of Nurses to conduct a risk assessment.  In a given day, you typically spend about 75% of the time on the phone with around 20-30- calls in a day.  You are also providing non-clinical support to the nurses with various duties such as scheduling appointments, reviewing and updating cases, contacting facilities to obtain missing/incorrect phone numbers, etc.  In order to be successful in this position, you must enjoy being on the phones, have excellent customer service skills, have an engaging personality to build relationships, and have a passion for wanting to help people. 

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.

Primary Responsibilities:

• Respond to incoming provider and enrollee calls
• Resolve customer service inquiries which could include:
• Enter notifications, Providers status of an existing notification and determining if notification is required.
• Complete notification wizard along with ICD-9 and CPT coding
• Provide excellent customer service to both providers and enrollees
• Constantly meet established productivity, schedule adherence, and quality standards while maintaining good attendance.
• Assist with faxes and emails
• Moderate work experience within own function.
• Some work is completed without established procedures.
• Basic tasks are completed without review by others.
• Supervision/guidance is required for higher level tasks.

Requirements:

• HS Diploma/GED
• 2+ years Professional experience do you have in an office setting using the telephone and computer as the primary instruments to perform the job duties.

Assets

• Experience with MS Word and Excel
• Experience with Sharepoint
• Healthcare or Insurance Benefits experience
• Professional experience in clerical or administrator work
• Medical Terminology/Coding (ICD-9 and CPT)
• Experience Call Center with high volume
• Experience working in a Hospital, physician, or medical clinical environment
  

OptumHealth is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.

OptumHealth helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their health care needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.

At OptumHealth, you will perform within an innovative culture that's focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that's greater than you've ever imagined.

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.