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 Processes all types of medical claims and adjusts medical disputed claims (Professional and Facility) according to department, contract, and regulatory requirements

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 Serves as a subject matter expert to cross functional staff regarding clinical services regulatory and delegation requirements, and impact to operational processes Serves as a

Process incoming data to deliver to internal staff; leading extract, transform, and load processes Develop and maintain data infrastructure to streamline and improve the processing systems Use statistical tools to interpret data sets, paying particular attention to trends and patterns that could be valuable for improving performance of internal programs Create data sets,

Supporting and assisting physicians with clinical care and task queue/inbox coverage at our group owned site Duties including but not limited to Rx refills, lab and radiology result verification, primary care clinical management (preventative, chronic and acute disease management, post discharge hospital and skilled nursing visits), referrals to specialists as needed Sche

Provides expert level review of inpatient clinical records within 24 48 hours of admit; identifies gaps in clinical documentation that need clarification for accurate code assignment to ensure the documentation accurately reflects the severity of the condition and acuity of care provided Conducts daily follow up communication with providers regarding existing clarificatio

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, c

Fully Remote | Flexible Scheduling

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

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

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

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

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

Manages ongoing contract relationships and service delivery to clients for up to 30 accounts Acts as outward facing, dedicated resource for assigned accounts, typically with direct client contact (not call center) and large or complex accounts Builds relationships with Provider leadership and serves as the primary point of contact for overall and day to day service delive