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Company

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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EducationHealth Care

H1B Sponsor Likely

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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

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Insurance verificationPrior authorizationMicrosoft OfficeEpicRetail medication knowledgeCphT certificationCMA certificationPayer portals experienceCoverMyMeds experienceClinical documentationPatient medical recordOutpatient healthcare experienceInpatient healthcare experienceClinical staff collaboration

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

Glassdoor

3.6

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

Founded in 2011

Eden Prairie, Minnesota, USA

10001+ employees

https://www.optum.com/

H1B Sponsorship

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Trends of Total Sponsorships

2023 (470)

2022 (822)

2021 (646)

2020 (458)