Healthcare Representative

Optum; Milton (MA); On-site; USD 37,000 - 67,000; Full time

Benefits offered by this job

Benefits package

401k contribution

Equity stock purchase

Job summary

Optum Insight in Milton, MA, onsite, seeks a patient services advocate to assist with benefit coverage applications and claims processing. The role requires interaction with hospital staff and government agencies within a fast-paced health care environment.

You will review medical records, expedite approvals, and maintain PHI/PII compliance while supporting hospital personnel and other Optum staff. Training occurs during normal hours, with some overtime possible.

Qualifications

• High School Diploma / GED or equivalent experience.
• Must be 18 years of age or older.
• 1+ years of customer service experience.
• Experience working in a group or office space setting.
• Experience with Microsoft Office products.
• Ability to work onsite at 199 Reedsdale Road, Milton, MA 02186.
• Ability to work full time Monday – Friday, with shift flexibility 8:00 am–5:00 pm and 1–2 weekend shifts per month.

Responsibilities

• Interview patients in a hospital setting and work effectively with hospital personnel to assist patients with obtaining maximum benefit coverage.
• Complete applications for state and federal programs.
• Review medical records and take all necessary actions to expedite benefit approval.
• Adhere to standards regarding PHI/PII and PTI.
• Maintain ongoing communication with government agencies regarding claims status.
• Provide updates and assistance to hospital personnel and Optum staff as needed.
• Maintain documentation of claims and client contracts in systems.
• Determine appropriate Federal, State or Local program applications based on medical disability definitions.

Skills

Customer service

Microsoft Office

Communication

Teamwork

Education

High School Diploma / GED

Tools

EPIC

Job description

This position is Onsite. Our office is located at 199 Reedsdale Road, Milton, MA 02186, Beth Israel Deaconess Hospital-Milton.

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together.

This position is full time Monday - Friday. Employees are required to have flexibility to work any of our shift schedules during our normal business hours of 8:00 am - 5:00 pm, with ability to work 1-2 weekend shifts per month. It may be necessary, given the business need, to work occasional overtime.

This will be on the job training, and the training hours will be during normal business hours.

Primary Responsibilities

• Interview patients in a hospital setting and work effectively with hospital personnel to assist patients with obtaining maximum benefit coverage
• Complete applications for state and federal programs
• Review medical records and take all necessary actions to expedite benefit approval
• Adhere to company and legal standards regarding Protected Health Information (PHI), Personal Identifiable Information (PII) and Personnel Transaction Identifier (PTI)
• Maintain ongoing communication with government agencies regarding the status of claims
• Provide updates and assistance to hospital personnel and other Optum staff as needed
• Maintain documentation of status of claims and client contract on Optum and / OR hospital computer systems
• Determine when to use a Federal, State OR Local program application based upon medical definition of disability as it relates to body systems and to functions of daily living, and information contained in medical records.
• Willing to work in a fast-paced hospital OR healthcare environment
• Other duties 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
• Must be 18 years of age OR older
• 1+ years of customer service experience
• Experience working in a group OR office space setting
• Experience with Microsoft Office products
• Ability to work onsite at 199 Reedsdale Road, Milton, MA 02186
• Ability to work full time Monday - Friday, with the flexibility to work any of our shift schedules during our normal business hours of 8:00 am - 5:00 pm, with ability to work 1-2 weekend shifts per month. It may be necessary, given the business need, to work occasional overtime.

Preferred Requirements

• 1+ years of Customer Service experience within a hospital OR healthcare environment
• Experience communicating with patients & staff with various educational & socio-economic backgrounds
• EPIC experience
• Knowledge of federal and state programs that will benefit coverage for clients
• Knowledge of medical terminology
• Bilingual fluency in English and Spanish

Soft Skills

• Excellent organizational skills
• Strong communication skills

Physical And Work Environment

• General office demands
• Prolonged periods of standing and walking in hospital facilities
• Adherence to facility masking requirements at all times

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 - $32 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 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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