Greets patients as they arrive and manage appropriate standard wait times Complete check in and check out tasks to include patient demographic verification, insurance verification, complete pre authorizations and/or precertification of procedures, and copy required documents Collects co payments, co insurance, and deductibles and issues receipts Manages cashier box and da

Combine two of the fastest growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. The

Combine two of the fastest growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably.

Greets patients as they arrive and manage appropriate standard wait times Complete check in and check out tasks to include patient demographic verification, insurance verification, and copy required documents Collects co payments, co insurance, and deductibles and issues receipts Manages cashier box and daily deposits according to company policies Answers phones and sched

Applies knowledge and skills to a range of moderately complex activities Demonstrates knowledge and expertise and skills in own function and processing of authorizations and tasks Acts as a technical resource for others to process work Proactively identifies solutions to non standard questions and requests Solves moderately complex problems independently Works with team t

Greets patients as they arrive and manage appropriate standard wait times Complete check in and check out tasks to include patient demographic verification, insurance verification, complete pre authorizations and/or precertification of procedures, and copy required documents Collects co payments, co insurance, and deductibles and issues receipts Manages cashier box and da

Primarily answering prior authorization with inbound calls (up to 50 to 70 calls per day) from members as well as research and resolve formulary and benefit issues using the appropriate reference material Process member prior authorization requests through various computer systems and use of job aid/policies/procedures ensuring the accuracy of all data and updating as nec

Positions in this function analyze and monitor claims against potential fraud, waste and abuse related to network pharmacies Investigate, review, and analyze claims data applying knowledge of pharmacy policy and practice and data mining techniques to determine details of potential fraudulent, erroneous, or abusive billing activity on Real Time Application System and vario

Delivers high quality patient care through face to face, telephone, and electronic contact for examination, treatment, monitoring, and preparing for diagnostic tests or procedures at various sites and departments within an assigned geographic region Collects and documents patient information, including vital signs, chief complaints, reviews of medications, allergies, heal

Consistently exhibit behavior and communication skills demonstrating Optum's commitment to superior customer service, including quality, care, and concern with every internal and external customer Perform all functions of a UM nurse reviewer Compose denial letter in a manner consistent with federal regulations, state regulations, health plan requirements and NCQA standard

Independently collaborates effectively with ED and outpatient care teams to establish an individualized transition plan for members Independently serves as the clinical liaison with hospital, clinical and administrative staff and performs transition of care/care coordination for ED discharges using evidenced based criteria within the documentation system Performs expedite

Consistently exhibits behavior and communication skills that demonstrate Optum's commitment to superior customer service, including quality, care and concern with each internal and external customer Perform all functions of the UM nurse reviewer Composes denial letter in a manner consistent with federal regulations, state regulations, health plan requirements and NCQA sta

Deliver high quality patient care through face to face, telephone, and electronic contact for examination, treatment, monitoring, and preparation for diagnostic tests or procedures Collect and document patient information, including vital signs, chief complaint, review of medications, allergies, health risk screen information, the status of extended care benefits, and oth

Oversee processing of physician adds, terms and demographic changes Review and verify provider panel status and current health plan IDs Manage and maintain current roster of primary care and specialty care physicians Support patient retention workflows during provider network changes Distribute materials, performance/patient data, and communications to physician network S

Consistently exhibits behavior and communication skills that demonstrate Optum's commitment to superior customer service, including quality, care and concern with each and every internal and external customer. Serves as a primary point of contact between patient and health care team to anticipate and appropriately address patient questions and concerns. Confirms patient u