Financial Clearance Representative Associate, Retail Pharmacy Prior Authorization jobs in United States
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Optum · 2 months ago

Financial Clearance Representative Associate, Retail Pharmacy Prior Authorization

Optum, in strategic partnership with Allina Health, is seeking a Financial Clearance Representative Associate to enhance health outcomes by connecting patients with necessary healthcare and financial services. The role involves verifying insurance eligibility, securing authorizations, and mentoring less experienced team members within the revenue cycle.

EducationHealth CareMedicalPharmaceutical
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H1B Sponsor Likelynote

Responsibilities

Verify insurance eligibility and completes automated insurance eligibility verification, when applicable and appropriately documents information in Epic
Confirm that a patient's health insurance(s) is active and covers the patient's medication
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
Initiating prior authorizations for medications

Qualification

Insurance verificationPrior authorizationRetail pharmacy knowledgeMicrosoft Office proficiencyEPIC experienceCustomer service skillsCphTCMA certificationWritten communicationVerbal communicationFast-paced environment

Required

High School Diploma/GED (or higher)
6+ months of experience with insurance and pharmacy benefit verification, pre-experience with prior authorization activities in healthcare business office/insurance operations
6+ months of experience using basic retail medication knowledge
Intermediate level of proficiency with Microsoft Office products
Must be 18 years of age OR older

Preferred

Associate degree or Vocational degree in Business Administration, Health Care Administration, Public Health, or Related Field of Study
Experience working with clinical staff
Previous experience working in outpatient and/or inpatient healthcare settings
Experience working in clinical documentation
Previous experience working with a patient's clinical medical record
Retail pharmacy experience
EPIC experience
Payer portals and/or covermymeds experience
CphT or CMA certification

Benefits

Comprehensive benefits package
Incentive and recognition programs
Equity stock purchase
401k contribution

Company

Optum is a healthcare company that provides pharmacy services, health care operations, and population health management. It is a sub-organization of UnitedHealth Group.

H1B Sponsorship

Optum has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (648)
2024 (559)
2023 (620)
2022 (851)
2021 (593)
2020 (438)

Funding

Current Stage
Late Stage

Leadership Team

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Daniel Castillo
Chief Executive Officer, Optum Care Delivery
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J
Jay Green
Chief Financial Officer
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Company data provided by crunchbase