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If you are located within 60 miles to Noblesville, IN, you will have the flexibility to telecommute* (work from home) 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 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.

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 8am - 4:30pm. It may be necessary, given the business need, to work occasional overtime. Our office is located at 18077 RIVER AVENUE Suite 205 Noblesville IN 46060.

We offer 2-3 weeks of paid training. The hours of training will be aligned with your schedule.

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

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 strong 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.

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

• Ability to work 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 8am - 4:30pm. It may be necessary, given the business need, to work occasional overtime.

Preferred Qualifications:

• 1+ years of healthcare administration experience

• 1+ years of Experience obtaining pre-authorizations from insurance companies

• Understanding and knowledge of insurance plans, coding (ICD-10 and CPT) and medical terminology.

Telecommuting Requirements:

• Reside within 60 miles to Noblesville, IN

• 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:

• Excellent customer service skills, for both internal and external parties.

• Excellent communication skills, written and verbal.

• 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 demonstrate consistent attention to details.

• Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.

• Ability to prepare reports and routine business correspondence.

• Ability to follow direction.

• Ability to think logically in order to troubleshoot, analyze situations, and make appropriate decisions using critical thinking and problem solving skills.

• Proficient computer skills, including working knowledge of Microsoft Office Suite, e-mail systems, and web­based programs. Knowledge of Electronic Health Record systems helpful, NextGen or Epic preferred.

• Ability to handle multiple tasks simultaneously.

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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