Prior Authorization Intake Coordinator - Telecommute

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US APPLICANTS ONLY: To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements, and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

Careers at UnitedHealth Group

We're creating opportunities in every corner of the health care marketplace to improve lives while we're building careers. At UnitedHealth Group, we support you with the latest tools, advanced training and the combined strength of high caliber co-workers who share your passion, your energy and your commitment to quality. Join us and start doing your life's best work. SM

Clinical

Compassion. It's the starting point for health care providers like you and it's what drives us every day as we put our exceptional skills together with a real feeling of caring for others. This is a place where your impact goes beyond providing care one patient at a time. Because here, every day, you're also providing leadership and contributing in ways that can affect millions for years to come. Ready for a new path? Learn more, and start doing your life's best work. SM

Our teams are helping people from around the world. We can bring out your best as you put your listening, analytical and problem solving skills to work in a setting that is geared to helping improve lives and enhance health care for millions. Here, you'll discover a wealth of pathways for professional growth within Customer Service, Billing, Claims, Enrollment & Eligibility and across our global economy. Join us and find out why this is the place to do your life's best work. SM

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life's best work.(sm)

WellMed provides concierge-level medical care and service for seniors, delivered by physicians and clinic staff that understand and care about the patient's health. WellMed's proactive approach focuses on prevention and the complete coordination of care for patients. WellMed is now part of the Optum division under the greater UnitedHealth Group umbrella.

Under the supervision of the UM Operations Supervisor, this position is responsible for the daily coordination of UM processes in the Intake Call Center. This position serves as the initial intake of pre - service requests, claim reviews and inpatient hospital coordination and diabetic supplies. Coordinates UM processes with Medical Directors, UM Nurses, hospitals, physicians and other various departments. Provides clerical support to clinical staff in their medical necessity review process. UM Coordinator is expected to maintain production and quality standards.

This position is full-time (40 hours/week) Monday-Friday. Employees are required to work our normal business hours of 7:00am-6:00pm CST. It may be necessary, given the business need, to work occasional overtime or weekends. Training will be conducted virtually from your home.

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:
  • Managing authorizations/notifications and other service requests received via incoming phone calls, faxes and portal submission
  • Providing excellent customer service, including the ability to handle escalated callers
  • Determining authorization or notification requirements
  • Preparing authorization cases for Medical Directors, UM Nurses and Case Managers
  • Providing administrative approvals (depends on line of business)
  • Handling expedited authorizations, authorization updates and status checks
  • Confirming member eligibility
  • Outreaches to providers and/or Patient to complete authorization requests and prescriptions
  • Maintaining knowledge of various health plan partner benefits, networks, CMS regulations and health plan partner policies
  • Utilizing experience and judgement to plan, accomplish goals and effectively resolve each assigned task
  • Non-Clinical staff is not responsible for conducting any UM activity that requires interpretation of clinical information
  • Performs all other related duties as assigned


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/GED (or higher)
  • 2+ years of combined or related experience in a healthcare, call center, and/or customer service setting using the telephone and computer as the primary instrument to perform job duties
  • Proficiency with Microsoft Office Word (create and maintain documents), Excel (create and maintain spreadsheets) and Outlook(email and calendaring)
  • Ability to work the hours of 9:00am - 6:00pm CST, Monday - Frida y

Preferred Qualifications:
  • Associate's Degree (or higher) in a healthcare related field
  • Medical Terminology knowledge
  • ICD-9/ICD-10 and CPT Knowledge

Telecommuting Requirements:
  • Required to have a dedicated work area established that is separated from other living areas and provides information privacy
  • Ability to keep all company sensitive documents secure (if applicable)
  • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service


UnitedHealth Group is an essential business. The health and safety of our team members is our highest priority, so we are taking a science driven approach to slowly welcome and transition some of our workforce back to the office with many safety protocols in place. We continue to monitor and assess before we confirm the return of each wave, paying specific attention to geography-specific trends. At this time, 90% of our non - clinical workforce transitioned to a work at home (remote) status. We have taken steps to ensure the safety of our 325,000 team members and their families, providing them with resources and support as they continue to serve the members, patients and customers who depend on us.

You can learn more about all we are doing to fight COVID-19 and support impacted communities at: https://www.unitedhealthgroup.com/newsroom/addressing-covid.html

Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at https://uhg.hr/transitioning-military

Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible. https://uhg.hr/vet

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Colorado Residents Only: The hourly range for Colorado residents is $15.00 to $25.19. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action 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.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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