Requisition number: 2359892
Job category: Healthcare Delivery, Patient Services
Optum NY/NJ, is seeking a Biller /Prior Authorization Specialist to join our team in Lake Success, NY. Optum is a clinician-led care organization that is changing the way clinicians work and live.
As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone.
At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.
Lake Success Rheumatology has an immediate opening for a friendly, patient focused and detailed oriented Billing and Prior Authorization Specialist to join our team. The Billing and Prior Authorization Specialist is responsible for the completion of set processes and protocols. Works cooperatively with all members of the care team to support the vision and mission of the organization, deliver excellent customer service and adhere to Lean processes. Supports the teams in meeting financial, clinical and service goals.
Schedule: This is a 37.5-hour work week, Monday through Thursday between the hours of 9:00 am to 5:00 pm. Friday 8:00 am to 3:00 pm shift to be determined by the hiring manager upon hire.
Location: 2 Ohio Drive, Suite 103 Lake Success, New York, 11042
Primary Responsibilities:
Load or update insurance information as needed
Knowledge of Infusion scheduling by medication treatment plan based on standards of care
File and fax records
Answers incoming phone calls in a courteous and prompt manner; directs calls and takes messages
Ability to maintain a work queue list- complete any pending actions i.e. referrals, scheduling appointments
Confirms and schedule appointments
Verify eligibility and authorization and flag appointment accordingly
Verifies insurance coverage, benefits, and creates price estimates, reverifications as needed
Ability to discuss with patients balances and co-pays
Schedule appointments using approved scheduling guidelines
Use call processing and other applicable functionality in the EHR to take messages and communicate with clinicians
Monitor administrative tasks in the EHR and respond timely
Assist coworkers as needed to ensure smooth office operation and delivery of excellent service through teamwork
Demonstrate respect for patients and Optum staff by presenting a friendly, courteous manner always and maintaining patient confidentiality
Manage claims denial
Interact with customers to gather support data to ensure invoice accuracy and work through specific billing discrepancies
Provide input to policies, systems, methods and procedures for the effective management and control of the premium billing function
Educate customers regarding the availability of receiving invoices and remitting payments through online applications
Monitor outstanding balances and take appropriate actions to ensure clients pay as billed
Manage the preparation of invoices and complete reconciliation of billing with accounts receivable
Knowledge of diagnosis and CPT codes
Manage appeals and follow up with pharmacies and insurance companies
Perform other duties as assigned
What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:
Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
Medical Plan options along with participation in a Health Spending Account or a Health Saving account
Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
401(k) Savings Plan, Employee Stock Purchase Plan
Education Reimbursement
Employee Discounts
Employee Assistance Program
Employee Referral Bonus Program
Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions 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
1+ years of computer proficiency experience in Microsoft Office
1+ years of experience working in medical office position performing duties such as insurance verification, obtaining pre-authorization, reviewing claims for errors before submission and maintaining appropriate medication schedules
Preferred Qualifications:
Experience working with an electronic health record (EPIC)
Knowledge of medical terminology
Knowledge of CPT and diagnosis codes
Soft Skills:
Ability to work independently and maintain good judgment and accountability
Demonstrated ability to work well with health care providers
Strong organizational and time management skills
Ability to multi-task and prioritize tasks to meet all deadlines
Ability to be empathetic and kind towards patients
Ability to work well under pressure in a fast-paced environment
Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying information in a manner that others can understand, as well as ability to understand and interpret information from others
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 $17.98 to $32.12 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
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 #RED
