Optum · 5 hours ago
Financial Clearance Representative Associate, Retail Pharmacy Prior Authorization - Remote near Minneapolis, MN
Minneapolis, MN
Full-time
Remote
Entry Level
1+ years exp
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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
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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
18 years 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 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
Company
Optum
Optum is a healthcare company that provides pharmacy services, health care operations, and population health management. It is a sub-organization of UnitedHealth Group.
10,001+ employees
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
2023 (470)
2022 (822)
2021 (646)
2020 (458)
Funding
Current Stage
Late StageLeadership Team
Daniel Castillo
CEO
J
Jay Green
Chief Financial Officer
Recent News
2024-05-31
Business Journals
2024-05-27
Company data provided by crunchbase
