Insurance Verification Representative - Remote In Bangor Metro Area

If you are located in Bangor Metro Area, you will have the flexibility to telecommute* as you take on some tough challenges.

Opportunities at Northern Light Health , in strategic partnership with Optum. Whether you are looking for a role in a clinical setting or supporting those who provide care, we have opportunities for you to make a difference in the lives of those we serve. As a statewide health care system in Maine, we work to personalize and streamline health care for our communities. If the place for you is at a large medical center, a rural community practice or home care, you will find it here. Join our compassionate culture, enjoy meaningful benefits and discover the meaning behind: Caring. Connecting. Growing together.

Performs insurance verification duties to financially clear the patient in advance of date of service. Verifies healthcare coverage and benefits for applicable services, working with the patient, provider, and payer to ensure accurate information and needs are met in advance of service.

This position is full-time (40 hours/week) Monday - Friday. Employees are required to to work 8:00am - 4:30pm EST and have flexibility to work onsite one week per quarter. It may be necessary, given the business need, to work occasional overtime. Our office is located at 43 Whiting Hill Road, Brewer, ME 04412.

We offer 2+ weeks of paid training (40hrs). The hours during training will be 7:30am to 4pm, Monday - Friday. Training will be conducted virtually from your home.

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

Primary Responsibilities:

• Attention to detail, multi-task, prioritize workload, ability to work independently, proficient navigating multiple systems, team player
• Previous experience working with prior authorizations and patient registrar is helpful but not required.
• Maintains and exhibits a current knowledge of insurance plans, associated workflows and information, and the impact of this role within the revenue cycle.
• May perform other duties upon request.
• Remains aware of department productivity expectations, and other measurable performance data and meets/exceeds individual contributions to the team performance.
• Partners closely with the clinical, office, billing, and registration teams and works to review authorizations timely, as applicable
• 30-70 insurance verifications per day.
• Escalates questions or concerns to leadership as needed.
• Identifies self pay patients and shares information with financial counseling for assistance with patient financial obligation and options.
• Metrics: quality, productivity, and accuracy
• Electronically verify insurance and review authorizations for scheduled procedures. Outbound calls to verify and follow up. F/up with ordering provider’s office to initiate the prior authorization.
• Representatives receive their assignments daily. Productivity goal is 55 accounts/day
• Outlook, Teams, multiple payor websites, EMR
• Maintains a safe environment complying with NLH policies and procedures; reports and directly addresses environmental hazards and violations of patient safety policy and/or protocol when involved or observed.
• Ensures excellent customer service when assisting patients, providers, and other departments
• Strives to maximize revenue and minimize bad debt.
• Collects and updates patient demographic and insurance information, making changes as necessary to ensure accuracy with insurance benefits, referrals, and authorizations.
• Appropriately documents all conversations with insurance companies and health care facilities that pertain to the authorizations or payment of services.
• Verifies precertification/authorizations for scheduled services utilizing internet sites, payer contacts, and software as appropriate. Assesses coverage and benefits, and accurately determines patient responsibility as applicable.

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:

• 6+ months experience in an office setting, customer service setting (over the phone or face to face) or phone support role or call center environment
• Familiarity with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
• Full COVID-19 and Flu vaccination are an essential job function 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. Candidates must be able to perform all essential job functions with or without reasonable accommodation.
• Ability to work onsite 1 week every quarter.
• High School Diploma / GED (or higher)

Preferred Qualifications:

• Understanding of medical terminology
• Working knowledge of insurance policies and procedures and patient care settings
• 1+ years of Patient Access experience in a hospital or medical setting

Telecommuting Requirements:

• 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
• Reside in commutable distance to office location: 43 Whiting Hill Road, Brewer, ME
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies required 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 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 Optum . Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

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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