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Pre Authorization Representative

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Optum

24d ago

  • Job
    Full-time
    Entry, Junior & Mid Level
  • Customer Relations
    Healthcare
  • Hyderabad, +1

AI generated summary

  • You must be at least 18, have a High School Diploma or GED, possess customer service experience in an office, and be skilled in Microsoft Office.
  • You will review patient information for authorization needs, ensure timely approvals, mentor team members, meet productivity goals, and comply with company policies and directives.

Requirements

  • Must be 18 years or older
  • High School Diploma or GED OR Equivalent Experience
  • Previous customer service experience in an office setting or professional work environment
  • Experience with Microsoft Office Products

Responsibilities

  • Review and analyze patient visit information to determine whether authorization is needed and understands payor specific criteria to appropriately secure authorization and clear the account prior to service where possible
  • Ensure that initial and all subsequent authorizations are obtained in a timely manner
  • May provide mentoring to less experienced team members on all aspects of the revenue cycle, payer issues, policy issues, or anything that impacts their role
  • Meet and maintain department productivity and quality expectations
  • Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so

FAQs

What is the role of a Pre Authorization Representative at Optum?

The Pre Authorization Representative is responsible for completing the financial clearance process, securing authorizations for patient services, and ensuring a positive first impression of Optum services to patients and their families.

What are the primary responsibilities of this position?

Primary responsibilities include reviewing patient visit information to determine authorization needs, obtaining timely authorizations, mentoring less experienced team members, meeting department productivity and quality expectations, and complying with company policies.

What qualifications are required for this position?

Required qualifications include being 18 years or older, having a High School Diploma or GED (or equivalent experience), previous customer service experience in an office setting, and familiarity with Microsoft Office products.

Are there any preferred qualifications for this role?

Preferred qualifications include an Associate or Vocational degree in Business Administration or related fields, experience with insurance and benefit verification, prior authorization activities, and working with clinical staff and documentation.

What soft skills are important for the Pre Authorization Representative?

Important soft skills include excellent customer service skills, strong written and verbal communication skills, and the ability to work efficiently in fast-paced environments.

Is prior healthcare experience necessary for this role?

While not required, having experience with insurance verification, prior authorization, or working in a healthcare office setting is preferred.

What kind of training will be provided to new team members?

New team members may receive mentoring from more experienced colleagues on various aspects of the revenue cycle and payer issues as part of their initial training.

How does Optum support diversity and inclusion in the workplace?

Optum fosters a culture of diversity and inclusion, believing that everyone deserves the opportunity to live their healthiest life, and is committed to addressing health disparities and improving health outcomes.

What is the company’s mission?

The company's mission is to help people live healthier lives and make the health system work better for everyone, with a focus on equity and reducing barriers to healthcare access.

What is the expected work environment for this position?

The work environment can vary and may include remote work options in a hybrid format, as well as collaboration with medical staff and other departments in a healthcare setting.

Science & Healthcare
Industry
10,001+
Employees

Mission & Purpose

Optum is a health services and technology company that provides a wide range of solutions to improve healthcare delivery and outcomes. They offer services in healthcare management, data analytics, pharmacy benefit management, and technology solutions to healthcare providers, payers, employers, and government agencies. Optum's ultimate mission is to improve the health system's efficiency and effectiveness, creating a healthier world for everyone. Their purpose lies in collaborating with healthcare partners to address complex challenges, such as improving care coordination, reducing healthcare costs, and enhancing patient experiences. By leveraging data-driven insights and innovative technology, Optum aims to empower healthcare professionals and organisations to deliver high-quality, patient-centered care and drive positive healthcare outcomes for individuals and communities worldwide.

Culture & Values

  • Integrity

    Honour commitments. Never compromise ethics.

  • Compassion

    Walk in the shoes of people we serve and those with whom we work.

  • Relationships

    Build trust through collaboration.

  • Innovation

    Invent the future, learn from the past.

  • Performance

    Demonstrate excellence in everything we do.