_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._
**Opportunities at Northern Light Health** , in strategic partnership with Optum. Whether you are looking for a role in a clinical setting or supporting those who provide care, we have opportunities for you to make a difference in the lives of those we serve. As a statewide health care system in Maine, we work to personalize and streamline health care for our communities. If the place for you is at a large medical center, a rural community practice or home care, you will find it here. Join our compassionate culture, enjoy meaningful benefits, and discover the meaning behind: **Caring. Connecting. Growing together.**
This position is full time. Employees are required to have the ability to work at least three shifts per month during the hours of 07:30am - 06:00pm EST. It may be necessary, given the business need, to work a per diem schedule (as needed), which includes rotating holidays & weekend shifts.
We offer 4 weeks of on-the-job training. The hours during training will be 8:00am to 4:30pm EST, Monday - Friday.
**Primary Responsibilities:**
+ Manage the intake of members or the admission/discharge information post notification.
+ Work with hospitals, clinics, facilities, and the clinical team to manage requests for services from members and/or providers.
+ Manage the referral process, processing incoming and outgoing referrals and prior authorizations, including intake, notification, and census roles.
+ Provide appropriate triage and care coordination notification cases for non-clinical assessment/intervention.
+ Handle resolution/inquiries from members and/or providers
This is high volume, customer service environment. You'll need to be efficient, productive, and thorough dealing with our members over the phone. You also must be able to work a flexible schedule that includes evening hours.
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
+ Must be 18 years of age OR older
+ 1+ years of healthcare customer service experience analyzing and solving customer problems
+ Experience working with Cerner (Electronic Medical Records)
+ Experience working with medical terminology
+ Proficiency with Microsoft Word and Excel (ability to create, edit, save, and send documents and spreadsheets)
+ Ability to train full time for the first four weeks between, Monday - Friday, 8:00am - 04:30pm EST
+ Ability to work full time. Employees are required to have the ability to work at least three shifts per month during the hours of 07:30am - 06:00pm EST. It may be necessary, given the business need, to work a per diem schedule (as needed), which includes rotating holidays & weekend shifts.
**Preferred Qualifications:**
+ Experience working within the health care Industry and with health care insurance
+ Clerical or administrative support background
+ Knowledge of ICD-9 and CPT codes
+ Experience working with Medicare and/or Medicaid Services
+ Medical Assistant
+ Call center experience
**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 $16.00 - $27.69 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._
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