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Assist in opening and closing the clinic, locking and unlocking the doors, and maintaining a clean waiting area Welcome all On Site Clinic patients and visitors by greeting them with a friendly demeanor, answering inquiries and directing them through the registration process. Answer multi phone lines, filing, faxing, scanning documentation and completing daily patient callbacks Collect all insuran
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Answer incoming phone calls from customers and identify the type of assistance the customer needs (i.e. benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs) Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems Own problem through to resolution on be
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Serve as a resource or Subject Matter Expert (SME) for other team members or internal customers Handle escalated calls, resolving more complex customer issues in a one and done manner Answer incoming phone calls from customers and identify the type of assistance the customer needs (i.e. benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs) A
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Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations Document clinical review findings, actions and outcomes in accordance with policies, and regulatory and accreditation requirements Engage with requesting providers as needed in peer to peer discussions Be knowledgeable in interpreting existing bene
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Great sales are the result of strong purpose, conviction and pride pride in your ability and your product. UnitedHealthcare offers a portfolio of products that are greatly improving the life of others. Bring along your passion and do your life's best work.(sm) Reporting to the National VP of Sales for the UnitedHealthcare Individual Exchange Business, the Regional VP of Sales (RVP) will hold respo
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As part of our Optum Digital team, you will have an opportunity to work on a high availability business critical application. Optum culture gives you plenty of opportunities to learn new skills and go deeper with the ones they already have. We are seeking people who are smart, charming and eager to learn. As a Lead Cloud/DevOps Engineer you will Work directly with application customer teams, MVP's
Posted Today
Great sales are the result of strong purpose, conviction and pride pride in your ability and your product. UnitedHealthcare offers a portfolio of products that are greatly improving the life of others. Bring along your passion and do your life's best work.(sm) Reporting to the National VP of Sales for the UnitedHealthcare Individual Exchange Business, the Regional VP of Sales (RVP) will hold respo
Posted Today
Establish and maintain positive clinical rapport with patients and their families, working closely with them in the provision of infusion therapy, education related to self care and self administration, and clinical monitoring of patient response to therapy Assess patient appropriateness for home infusion therapy, including safety of the home environment, availability of caregiver support, and wil
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Leveraging clinical operations knowledge and industry expertise, develops programs to improve health care quality and cost, including utilization management programs, value based payment initiatives, and innovative member facing and/or digital technology enabled programs focused on musculoskeletal health Works across the organization with other business partners in Network and Clinical Operations
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Manage unit cost budgets, target setting, performance reporting and associated financial models Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards and other key process controls Forecast and plan ongoing contract renewal strategy Assess and interpret customer needs and requirements Identify solutions to non standard requests and problems Work w
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Manages the patient care process by ensuring that a comprehensive patient assessment and plan of care is completed and documented on all patients within the time frame of the established policy. Manages staff members, assesses the needs of patients, and delegates tasks appropriately. Facilitates in the development of department level plan for financial and personnel resources required to provide t
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Work with onshore and offshore resources to ensure stability of applications Accountable for ensuring that incident and problem tickets are effectively addressed through management of multiple avenues Develop and manage weekly and monthly reporting Accountable for ensuring application availability, SLA, productivity and cost metrics goals are met Work closely with business and development teams to
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Assists the provider with examinations, procedures, and other duties Complete provider orders per state and provider regulations Performs biometric visits including testing, documentation and patient education of at risk biometrics. Responsible for screening and accurate detailed clinical intake of patients and updating medical records Oversee and coordinate the daily patient care flow Assist pati
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Triage requests into correct categories Document request as A&G Correspondence or A&G Appeal Ensure accurate data entry Prioritize work based on due date and run applicable work list reports to monitor workload Plans, prioritize, organize and complete work to meet established and required timeframes Determine if appeal is clinical or administrative Ensure correct letter template is utilized Comple
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Complete State of Florida end to end prospective and retrospective Overpayment Audit reviews for monthly and annual HMS audits and internal recovery audit process with Optum and UnitedHealthcare Promote consistency in the audit review process by overseeing and improving the documentation and overpayment recovery efforts as it pertains to State of Florida end to end audit requirements Support and d
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