Pre-Registration Clearance Representative – National Remote

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.   

This position will work in Arizona business hours, regardless of the employee’s location within the United States. This would typically be Monday to Friday from 9am to 5:00pm AZ time with a 30-minute lunch break.

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

Primary Responsibilities:

• Verifies insurance eligibility and obtains benefits on all scheduled patient accounts by using electronic verification systems or by contacting payers directly to determine the level of insurance coverage
• Document insurance benefit information such as, deductibles, co-payments, coinsurance, and policy limitations
• Secures or verifies authorization and pre-certification
• Completes medical necessity check for outpatient services when Medicare is the payer using the diagnosis and procedure codes provided on the physicians’ order
• Completes the Advanced Beneficiary Notification (ABN) process if/when the code does not pass medical necessity
• Calculates patient’s financial responsibility
• Review assigned accounts to ensure accuracy and required documentation is obtained and complete
• Follows appropriate processes and procedures to ensure accurate billing and timely processes
• Collects and enters required data into the system with emphasis on accuracy of demographic and financial information to ensure appropriate reimbursement
• Other duties as needed and assigned by their Manager, Director and or Senior Director

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) 
• 1+ years of experience working with patient access & registration
• 1+ years of experience working with health insurance
• Ability to work Arizona’s standard business hours (approximately 9am to 5:00pm Arizona Time Monday to Friday)

Preferred Qualifications:

• Experience with Microsoft Office products
• Good typing skills and communication skills
• Working knowledge of medical terminology
• Ability to perform basic mathematics for financial payments
• Experience in requesting and processing financial payments

Soft Skills:

• Strong interpersonal, communication and customer service skills 
• Attention to detail

*All Telecommuters 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 to $31.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. 

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 #GREEN