If you are located within 1-hour commutable distance to the office in Marlborough, MA, 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.

All of us have a short list of the things that make a job great. If your list includes being able to make a difference, count us in as your next place to work. UnitedHealth Group is a Fortune 5 company leader in health care at a time when health care is evolving for everyone. Our billing teams are part of an important chain of events that impact the lives of our members in positive ways. Join this group and we’ll have an impact on you. Apply now and discover the exceptional training, support, and opportunities to grow that you’d expect from a Fortune 5 company.

This position is full-time. Employees are required to work our normal business hours of 8:00am – 5:00pm. It may be necessary, given the business need, to work occasional overtime or weekends. Our office is located at 200 Forest Street, Marlborough, MA 01752.

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

Primary Responsibilities:

• Process preauthorization/predeterminations for all contracted insurances when appropriate
• Interact with clients to obtain medical records that will support the services being ordered
• Provide contracted insurance the records, CPT and ICD10 codes to determine medical necessity
• Follow-up with clients when necessary, so filing limits to perform a preauthorization aren’t missed
• Provide input to policies, systems, methods and procedures for the effective management and control of the premium billing function

What makes this a special challenge? For one, we want to create a quality experience for every person we serve. So, the bar is high for accuracy, communications style, and effectiveness. Also, you’ll need to be researching and resolving problems before, during and after calls within a high volume, demanding environment.

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) OR equivalent years of working experience
• Previous experience in billing or collections
• Knowledge of and experience with ICD-10, HCPCS, and modifier coding
• Understanding of Reimbursement, Health Care Plans, Claim Processing, Medical Terminology
• Proficiency with Windows PC applications, which includes the ability to navigate multiple programs and learn new and complex computer system applications
• Able to work a 40-hour schedule, full-time. Employees are required to work our normal business hours of 8:00am – 5:00pm. It may be necessary, given the business need, to work occasional overtime or weekends.

Preferred Qualifications:

• 1+ years of experience in a related environment (i.e., office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools

Telecommuting Requirements:

• Reside within 1-hour commutable distance to the office in Marlborough, MA
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Ability to keep all company sensitive documents secure (if applicable)
• 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:

• Ability to multi-task and to understand multiple products and multiple levels of benefits within each product

Taking care of business at UnitedHealth Group translates to more meaning and impact as you help improve the lives of millions. Join us. Learn more about how you can start doing your life’s best work. SM

Careers with OptumInsight . Information and technology have amazing power to transform the Healthcare industry and improve people's lives. This is where it's happening. This is where you'll help solve the problems that have never been solved. We're freeing information so it can be used safely and securely wherever it's needed. We're creating the very best ideas that can most easily be put into action to help our clients improve the quality of care and lower costs for millions. This is where the best and the brightest work together to make positive change a reality. This is the place to do your life’s best work. SM

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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