Optum Chart Review Jobs in Kansas (NOW HIRING)

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

Job Summary

Making phone calls to schedule and reschedule patients. Verifies patient demographic and insurance information. Prepares patient chart for visit with practitioners. Performs general clerical duties. Meets the communication needs of the patient/family, practice providers and practice staff. Participates in performance improvement activities. Responsible for supporting providers and other team members in loading documents into Epic EMR. Responsible for daily office tasks.

Schedule: FT, 40 hours. Monday - Friday, 8am - 5pm CST or 9am - 6pm EST

Location: This is a remote role; candidates must reside in Kansas, Missouri, Indiana or Ohio.

You'll enjoy the flexibility to telecommute* if you reside in Kansas, Missouri, Indiana or Ohio as you take on some tough challenges.

Primary Responsibilities

• Respond to patient questions in person or over the phone
• Greet patients and build rapport to provide a positive patient experience
• Input/update patient demographic data into computer system
• Make patient follow up calls to identify/close gaps in care
• Ensure provider templates/procedures are built correctly to schedule appointments in appropriate time slots
• Appointment reminder calls and reschedules
• Ask patient questions to verify patient data or needs for scheduling
• Coordinate/confirm scheduling of doctor visits/services with patients
• Make calls to doctor's office on patient's behalf to schedule, check progress, and facilitate the care process
• Ask patients for and/or assist patients with completing required paperwork (e.g., health history, insurance documentation, etc.)
• Connect patients with outside resources (e.g., community resources, social services) to promote self-care
• Work directly with patients to identify specific needs and/or request adjustments to plan of care
• Manage/respond constructively to challenging patient interactions (e.g., address lack of understanding, socioeconomic challenges, frustrated patients, language barriers)
• Explain and talk to patients or caregivers about sensitive health care decisions
• Explain and ensure understanding of details related to patient care (e.g. outside referrals, medications, etc.)
• Explain medical benefits/coverage specifics (e.g., procedures/amounts covered, denials of coverage, appeal rights)
• Access insurance plan systems to verify insurance eligibility/benefits for patients and seek additional information as necessary
• Update/upload patient care data (e.g., care plan data, inpatient data, patient program data) in computer systems
• Enter/process patient referral data (e.g., medical services, radiology, durable medical equipment)
• Verify referral approval prior to scheduling appointments
• Manage patient referral process (e.g., review for duplicates, ensure referral is sent to appropriate provider, follow-up with requesting provider to recommend changes)
• Ensures patient scheduling/follow up activities are completed according to federal, state, or organizational guidelines (e.g., referral guidelines, follow up notifications, PCP follow up)
• Draft/provide written communications to patients (e.g., standard letters, welcome letters, educational materials) in compliance with company and health plan guidelines
• Make calls to doctor's office on patient's behalf to schedule, check progress, and facilitate the care process
• Identify resources available to support patient care (e.g., housing, social services, meals)
• Maintain open communication and rapport with physicians to promote patient services/care
• Screens/forwards incoming calls from patients, physicians, and health plans
• Monitors, the no-show and other work queues
• Accurately enter patient demographics, guarantor, and coverage information into Epic EMR.
• Accurately change filing order, ensure necessary adjustments are listed on account, distribute payments to correct service dates and request changes if needed.
• Attend meetings regarding team/department updates, etc.
• Assist insurance companies/guarantors with questions regarding charges and balances.
• Work with other departments to resolve issues affecting reimbursement.
• Going through faxes
• Scanning all documents in Epic
• Creating and/or Responding to Letters and Forms
• Other assigned duties

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
• 1 year of healthcare experience using Epic or similar EMR
• Must reside in Kansas, Ohio, Missouri or Indiana

Soft Skills:

• Demonstrate understanding of relevant health plan guidelines and benefits (e.g., Medicare, Medicaid/Medical, commercial benefit plans, Federal/local government regulations)
• Demonstrate understanding of Federal privacy regulations (e.g., HIPAA)
• Demonstrate knowledge of safety guidelines/practices (e.g., OSHA)
• Demonstrate knowledge of basic medical terminology and human anatomy to document patient information using standard language/medical terminology

Preferred Qualifications:

• Work from home experience

*All Telecommuters 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 $18.00 to $32.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.  

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

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.

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.

#RPO, #GREEN