Position Description:
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 position also includes intake, notification and census roles as well as managing calls and resolution of claims/customer service issues, and benefits inquiries.
Do you want meaning in your career as a clinician or a business professional? If so, OptumHealth Behavioral Solutions is looking for individuals willing to help people live healthier lives by providing them with information, tools and solutions to achieve their health and well-being goals!
Our Call Operations center is seeking individuals who are interested in providing expertise and support to our members, providers and customers on a part-time basis. This is a great opportunity for individuals who are looking to return to the workforce and make a commitment to a part-time position or looking for a position that fits within their current schedules. This position offers great work-life balance and a competitive hourly wage.
Training will be full time for 3 or 5 weeks from 8:00 AM – 4:30 PM, Monday – Friday.
Primary Responsibilities:
- Initial triage of members, administrative intake of members or managing the admission/discharge information post-notification, working with hospitals and the clinical team.
- Manage incoming calls, managing requests for services from providers/members, providing information on available network services and transferring members as appropriate to clinical staff.
- Manage the referrals process, processes incoming and outgoing referrals, and prior authorizations.
- Includes intake, notification and census roles.
- Resolve provider/member inquiries which could include:
- Benefit and Eligibility information
- Billing and Payment issues
- Customer material requests
- Physician assignments
- Authorization for treatment
- Explanation of Benefits (EOB)
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