_This position is National Remote. You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges._ **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.** This position is full-time (40 hours/week) Monday - Friday. Employees are required to work our normal business hours of 6:00 AM - 7:00 PM EST. It may be necessary, given the business need, to work possible occasional overtime. We offer 4 weeks of paid training. The hours during training will be 8:00am to 5:00pm CST, Monday - Friday. Training will be conducted virtually from your home. **Primary Responsibilities:** + Point of contact for providers or members regarding medical/pharmacy/clinical services or benefits. + Review fax and electronic referral requests for medical or clinical services. + Enter medical request data into relevant computer system. + Utilize phone system to respond and transfer inbound calls transfer calls to appropriate individuals. + Access electronic member files in external portal using appropriate patient identification. + Review benefits and authorization requirements from the central BA team, create additional pharmacy test claims (if applicable), and patient responsibility. + Participate in on call rotation with the possibility of staggering shifts. + Check procedure codes against notification requirements and benefit coverage to determine next steps. + Reference job aid tools via the computer to identify appropriate procedures when needed. + Document, review and interpret historical documentation (e.g., MAR, H &P). + Navigate between computer screens and platforms to research information (e.g., medical, clinical, or benefits information). + Reference and follow automated job aid tools via computer to research relevant rules, regulations, or policy/procedures. + Learn computer system and process changes and updates and incorporate into daily work. + Participate in routine meetings with team and branch members and update the team with relevant patient information. + Contact internal resources if necessary to clarify information. + Identify appropriate resource (e.g., doctor, resource, contracted provider) to respond to medical requests. + Provide/explain benefit information to providers and patients. + Obtain verbal and written consent (PSA) to treat from patients. + Collect patient pay portions upon admission to services. + Communicate with multidisciplinary teams to ensure coordination is complete for the onboarding of the patient. + Review and advise member/provider of status of a request (e.g., notification, authorization). + Perform patient onboarding tasks in the Cloud workflow within the approved turnaround times. + Update and/or add prescribers during the onboarding process. + Add other 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 equivalent work experience + Must be 18 years OR Older + 2+ years of experience with analyzing and solving customer problems + 2+ years of experience with working in the Health Care Industry + Ability to work any 8-hour shift between the hours of 8:00 AM - 5:00 PM from Monday - Friday including the flexibility to work possible occasional overtime per business need **Preferred Qualifications:** + Experience working with Health Care Insurance + Experience in a Hospital, Physician's Office, OR Medical Clinic setting + Clerical OR Administrative support background OR experience working in a Call Center environment + Experience working with Medicare and / OR Medicaid Services **Telecommuting Requirements:** + Ability to keep all company sensitive documents secure (if applicable) + Required to have a dedicated work area established that is separated from other living areas and provides information privacy. + Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service. *All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you’ll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.74 - $31.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable. **_Application Deadline:_** _This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants._ _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._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._ \#RPO