Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm)
Under the supervision of the Referral Management Supervisor, this position is responsible for the daily coordination of referral processes and other duties as assigned.
If you are located in Irving, TX, you will have the flexibility to telecommute* as you take on some tough challenges. This is Office Based; potential telecommute.
*** Bilingual English / Spanish speaking highly preferred***
- Manage the internal/ external referral process and daily referral reconciliation gathering required information and documents needed, working them accordingly in compliance with established timelines
- Answers telephone and assists caller through the phone queue with scheduling and other needs based on the call type
- Participate in clinic and market education, training, and meetings as needed and/or required
- Maintains knowledge and ensures procedures are followed including referral guidelines and policies, privacy, and confidentiality
- Deliver quality customer service, managing the referral process professionally and in a timely manner maintaining professionalism and a positive attitude with all internal and external customers/peers
- Ability to work independently
- Obtain and update prior authorizations and referral authorizations for both internal and external specialty offices
- Being a patient advocate for quality healthcare in external facilities, maintaining the strictest confidentiality
- Retain and utilize knowledge of insurance policies and procedures
- Performs all other related 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.
- High school diploma or GED equivalent
- 1+ years of Health Care related experience
- Efficient proficiency in Microsoft Office applications including: Excel, Word and Outlook
- Able to navigate through multiple software and computer technology
- Knowledge of medical terminology
- Full COVID-19 vaccination is an essential requirement of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance
- 1+ years of Referral management experience
- 1+ years of Medical Insurance experience
- 1+ years of Customer Service
- Bilingual English / Spanish Speaking
- Effective verbal and written communication skills
- Solid customer service skills
- Detail oriented with organizational and time management skills
Physical and Mental Requirements:
- Ability to sit for extended periods of time
- Ability to receive and comprehend and carryout instructions verbally and/or in writing
- Ability to use logical reasoning for simple and complex problem solving
- Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions
USMD part of OptumCare is a multi-specialty group of hospital, clinics and physicians. USMD serves the Dallas-Fort Worth metropolitan area with more than 250 physicians and associate practitioners, and provides healthcare services to patients in more than 20 different specialties at its 2 hospitals, 4 cancer treatment centers and nearly 50 physician clinics, many of which are multi-specialty.
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment
Careers with USMD. If you’re idea of a great day at work involves putting great new ideas to work, we should talk. Throughout the greater Dallas area, we’ve built an evolving, integrated health care model that brings primary care and specialist providers together to work in new and better ways. A thriving part of OptumCare and the UnitedHealth Group family of companies, our multi - specialty group of hospitals, clinics and providers features more than 250 physicians and associate practitioners. We provide health care services to patients in more than 20 different specialties at our two hospitals, four cancer treatment centers and nearly 50 physician clinics. Join us and start doing your life’s best work.(sm)
WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.