Opportunities with Optum in the Tri-State region (formerly CareMount Medical, ProHEALTH New York and Riverside Medical Group). Come make a difference in the lives of people who turn to us for care at one of our hundreds of locations across New York, New Jersey and Connecticut. Work with state-of-the-art technology and brilliant co-workers who share your passion for helping people feel their best. Join a dynamic health care organization and discover the meaning behind Caring. Connecting. Growing together.
This position is full-time Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 4:00 pm. Our office is located at 116 E 16TH ST New York, NY
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We offer 2 weeks of on-the-job training. The hours of training will be aligned with your schedule.
Primary Responsibilities:
- Verify patients' insurance eligibility and benefits by contacting insurance companies or utilizing online systems.
- Collect and input accurate insurance information into the organization's systems.
- Identify issues related to coverage and resolve discrepancies between the patient and the insurance provider.
- Obtain prior authorization for therapy services as required by the insurance company.
- Coordinate with healthcare providers to ensure that necessary documentation is submitted to insurance companies for approval.
- Follow up on outstanding authorizations to ensure timely processing and prevent delays in patient care.
- Serve as a point of contact between insurance companies, patients, and healthcare providers.
- Provide patients with detailed information regarding their insurance coverage, including potential out-of-pocket costs and co-pays.
- Inform the clinical and billing teams of any changes in patient insurance status or coverage restrictions.
- Maintain accurate and up-to-date records of insurance verification and authorization requests.
- Ensure all insurance-related documentation is properly filed and accessible for auditing purposes.
- Document all interactions with insurance companies and patients to ensure clear and accurate communication.
- Resolve issues related to denied claims, incorrect insurance information, or insufficient authorization.
- Work with the insurance company and the billing team to address and rectify any discrepancies.
- Ensure that all insurance verification and authorization processes comply with applicable healthcare regulations, insurance policies, and industry standards.
- Stay updated on any changes in insurance policies, procedures, and medical billing codes.
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 experience in insurance verification, medical billing, OR authorization roles, preferably in physical therapy OR similar healthcare services
- Understanding of insurance policies, coverage, and prior authorization procedures
- Knowledge of insurance policies across a wide variety of providers (e.g., PPO, HMO, Medicare, Medicaid, Workers' Compensation)
- Knowledge of ICD-10, CPT, and HCPCS coding
- Experience with Epic EHR and billing technologies
- Ability to work between the hours of 8:00 am - 4:00 pm from Monday - Friday
Preferred Qualifications:
- Billing / coding certification and ongoing continuing education (a plus)
The hourly range for this role is $16.88 to $33.22 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.
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.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
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