Referral Coordinator - Colorado Springs- Remote

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. 

This position will process multi-practice requests for all services that require referrals and pre-authorization in a manner that ensures timeliness, accuracy, and maximum reimbursement.

If you are located within Colorado Springs, CO you will have the flexibility to work remotely* as you take on some tough challenges. This position will complete 90 days of training at our office located in Colorado Springs, CO. This position has the opportunity to work remotely post training. 

Primary Responsibilities: 

• Receives, reviews and coordinates all information required to initiate a referral for pre-authorization for health care services for multiple practices
• Follows protocols and practice guidelines set up by Optum and contracted payors
• Advises providers concerning the adequacy of the information contained in the referral.  Makes suggestions within the protocols of the referral manual
• Maintains accurate documentation of the referral in the patient’s medical record
• Maintains a communication log or tracking system for follow-up, data gathering and analysis
• Communicates to patients and providers in the referral network in a timely manner the status or completion of the referral and any information required to ensure continuity of care to the patient.  Documents communication as required to ensure service excellence
• Maintains an effective working relationship with Medical Management staff of Optum, with the office staff of referral providers, and with the office staff of contracted insurance companies.  Documents communication as required to maintain service excellence
• Communicates in a timely manner to patient’s primary care physician referrals that are denied or that require more information for approval
• Demonstrates critical thinking skills and effective communication skills in investigating breakdowns in the referral process to ensure positive working relationships with everyone involved
• Demonstrates excellent customer service skills:  warm, respectful, gracious, and courteous in all communications.  Notifies practice manager of referral breakdowns and patient complaints
• Educates patients and staff on changes in the referral process, alternatives available within the insurance plan and consequences of out-of-plan services
• Maintains knowledge base of service plan benefits, criteria for plan enrollment and eligibility timeframes, and resources available to the patient within the plan for information on plan services
• Other duties as assigned
• HIPAA Security Level:  High access to systems/patient information

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: 

• 1 years of applied knowledge in managed care environment 
• 1 years of hands-on experience in computer data entry and telephone customer service
• Solid working knowledge of medical terminology

Colorado Residents Only: The hourly range for Colorado residents is $16.00 to $28.27 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. 

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy