Energize your career with one of Healthcares fastest growing companies.
You dream of a great career with a great company where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, its a dream that definitely can come true. Already one of the worlds leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.
This opportunity is with one of our most exciting business areas: Optum a growing part of our family of companies that make UnitedHealth Group a Fortune 17 leader.
Optum 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 healthcare 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.
Responds to telephone inquiries and written correspondence from members and providers related to claims payments, benefits and eligibility, and authorization issues
Provide excellent customer service to external providers
Documenting external class in TRES, with outcome of biller or provider call
Investigates issues and documents steps to achieve resolution
Manages resolution of issues through contact with Optum Claims Department, Utilization Management, and external payers to achieve a positive outcome to the issues
Confirm Medi-Cal eligibility for MFT providers on the same day received via fax
Investigate sand handles retro-authorization activities, as required for resolution
Follow-up and complete claims in reviews on a daily weekly basis
Navigate multiple reports on a daily basis to capture potential processing, data entry errors
Review claims for eligibiliy confirmation through reports on a daily basis through Monthly Meds Extract File (MMEF), designated database
Responds to providers regarding the status of formal complaints or appeals
Maintains accountability for total problem resolution and communicates resolution to appropriate parties
Assist with special projects and perform other duties as assigned
Position requires access to electronic applications and documents which contain Individually Identifiable Health Information and Personal Health Information
UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.
We are committed to introducing innovative approaches, products and services that can improve personal health and promote healthier populations in local communities. Our core capabilities... in clinical care resources, information and technology uniquely enable us to meet the evolving needs of a changing health care environment as millions more Americans enter a structured system of health benefits and we help build a stronger, higher quality health system that is sustainable for the long term.
We serve our clients and consumers through two distinct platforms:
?UnitedHealthcare, which provides health care coverage and benefits services.
?Optum, which provides information and technology-enabled health services.