TELECOMMUTE WITH RESTRICTIONS

Candidates must be located in IN OR OH within CST or EST.

Opportunities with American Health Network, a Part of Optum. When you join American Health Network (AHN), you become part of a team that strives to identify and retain the top healthcare professionals in the markets it serves. At American Health Network, we want to be the best health care organization we can be. Our mission is to improve the health of our patients. We’re a physician-led organization, operating over 70 medical offices in Indiana and Ohio, with over 300 providers and 1200 employees. We’re also an OptumCare partner, part of the UnitedHealth Group family of businesses, and backed by the resources of a global health care organization working to help people live healthier lives and help make the health system work better for everyone. That’s an important differentiator as more people need our help simplifying the complexities of the American health care system. At the same time, the culture of AHN supports work-life flexibility for providers and places a high value on their physical, emotional, financial, and other aspects of well-being.

The Referral Coordinator is responsible for timely and accurately processing referrals and secures pre-authorizations when necessary. In addition, the Referral Coordinator acts as a liaison between primary care providers, specialists, insurance companies and patients.

Schedule: Monday-Friday, 8am-4:30pm. No evenings, weekends, or holidays!

Location: 18077 River Road, Noblesville, IN

*This role has the potential to work remotely. Candidates must reside in Indiana or Ohio.

Primary Responsibilities:

• Following the process, receives and documents referrals in the referral tracking system, schedules care based on clinical protocols, and sends confirmation of scheduled services to both the referring provider and the patient
• Accurately enters all referral information into appropriate systems daily in order to facilitate complete medical records
• Ensures patient demographic and insurance information accompanying the referral is accurate and complete; follows up as needed to obtain missing or correct information
• Ensures specialists have all clinical information necessary for referral appointments, and sends any additional documents upon request
• Obtains pre-authorizations and pre-certifications from third-party payers in accordance with payer requirements. Documents the authorization number and period of validity in referral tracking system
• Gathers additional medical records from providers as needed to support medical necessity when obtaining a pre-authorization, and follows up with payers on pre-authorization requests as needed
• Identifies and provides information to patients who will need to receive Medicare Advance Beneficiary Notices of No Coverage
• Alerts the clinicians involved in the patient’s care when there are issues with referrals or complications with insurance coverage
• Informs the patient whether the authorization for the referral has been approved and reviews the next steps of care with them, including providing appointment reminders
• Collaborates with areas such as financial counseling, care management, and others when patients may need or qualify for additional financial or care coordination programs
• Establishes and maintains solid working relationships between primary care providers, specialists, and patients. Leverages knowledge of internal primary and specialty care providers and processes to assist in the referral and/or pre-authorization processes
• Obtains and maintains thorough knowledge of insurance plans accepted by the company as well as preauthorization requirements for contracted commercial and governmental plans
• Attends meetings and participates on committees as requested
• Reviews current literature and attends training sessions and seminars to keep informed of new developments and changes within the field
• Performs other related duties and responsibilities as directed
• Complies with all company policies and procedures regarding HIPAA and handling of PHI
  

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.)
• More information can be downloaded at: http://uhg.hr/uhgbenefits
  

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 higher)
• 1+ years of experience in a healthcare administration or similar role
• 1+ years of experience with insurance plans, coding (ICD-10 and CPT) and medical terminology
• 1+ years of experience with referrals and authorizations
  

Preferred Qualifications:

• Associate's degree in healthcare or business administration and/or related coursework, or comparable experience
• Experience obtaining pre-authorizations from insurance companies
• Proven ability to interact and communicate with a variety of people, both on a one-on-one basis and/or over the telephone. Must be able to relate to and work with ill, emotionally upset, and sometimes hostile people
• Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals
• Proven ability to prepare reports and routine business correspondence
• Proficient computer skills, including working knowledge of Microsoft Office Suite, e-mail systems, and web- based programs
• Knowledge of Electronic Health Record systems, NextGen or Epic
  

Soft Skills:

• Ability to work in a fast-paced office environment
• Ability to stand and sit for periods of time and to move intermittently throughout the workday
• Solid sensory skills, such as visual acuity, good hearing, and dexterity
• Ability to occasionally push, pull, lift, move, and/or carry up to 15 pounds with or without assistance
• Good speaking and listening skills
• Ability to perform focused work with close attention to detail
• Ability to operate office equipment, including computers, copiers, fax machines, and phones
• Ability to interact with others, both in person and through phone, e-mail, and written correspondence
• Excellent customer service skills, for both internal and external parties
• Excellent communication skills, written and verbal
• Ability to follow direction
• Ability to handle multiple tasks simultaneously
• Ability to demonstrate consistent attention to details
• Ability to think logically in order to troubleshoot, analyze situations, and make appropriate decisions using critical thinking and problem-solving skills
  

Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

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.