Patient Access Specialist - National Remote

  • Boston
  • Unitedhealth Group

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

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, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

The Patient Access Specialist is responsible for scheduling and collecting necessary information for all Pre-service departments following the Schegistration model. Ensures the integrity of registration data collected, including insurance and benefit verification, acquisition of referrals and pre-certifications for procedures, and collection of patient financial liability.

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 7:00 AM – 7:00 PM EST. It may be necessary, given the business need, to work occasional overtime.

We offer weeks of on-the-job training. The hours during training will be 8:00am to 5:00pm EST, Monday - Friday.  Training will be conducted virtually from your home.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary Responsibilities:

  • Schedules patient appointments obtaining all patient demographic, insurance, diagnosis and procedure information and verifies accurate insurance plan code assignment.
  • Works with doctor’s offices to ensure an authorization has been obtained for all services requiring one.
  • Informs patients and providers that a necessary authorization has not been obtained or that a procedure is being flagged as not medically necessary and that the patient may need to sign a non-covered services waiver on arrival.
  • Utilize clinical knowledge to determine if the doctor’s order is consistent with the diagnosis provided.
  • Coordinates schedules with anesthesiologists, radiologists and other providers.
  • Informs patients of necessary advance preparation for procedures.
  • Checking patient eligibility and benefits for procedure scheduled. Preforming patient estimates and providing patient information on possible liability.
  • P.O.S. collections.
  • Coordinates appointments for patients with multiple procedures.
  • Ensures test results and prior films and reports are obtained.
  • Performs schedule blocks as indicated.
  • Meets productivity standards, quality review expectations, unit specific goals and reporting requirements as assigned.

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 OR equivalent experience
  • 2+ years of customer service experience in a hospital, office setting, customer service setting, OR phone support role
  • 1+ years of electronic health record experience
  • Must be 18 years of age or older
  • Ability to work any 8-hour shift between the hours of 7:00 AM - 7:00 PM EST from Monday - Friday including the flexibility to work occasional overtime based on business need

Preferred Qualifications:

  • 1+ years of experience with prior authorizations, or scheduling
  • Experience with using Microsoft Office products
  • Experience in a hospital patient registration department, physician’s office, OR any medical setting
  • Working knowledge of medical terminology
  • Understanding of insurance policies and procedures
  • Experience in insurance verifications
  • Ability to perform basic mathematics for financial payments
  • Experience in requesting and processing financial payments

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

Soft Skills:

  • Strong interpersonal, communication, and customer service skills

California, Colorado, Connecticut, Nevada, New Jersey, New York, Washington or Rhode Island Residents Only: The hourly range for California / Colorado / Connecticut / Nevada / New York / New Jersey / Washington / Rhode Island residents is $16.00 - $27.31 per hour. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.