UnitedHealth Group is a healthcare and well-being company that’s dedicated to improving the health outcomes of millions around the world. We are comprised of
Specialty Navigator I
Location
Massachusetts
Posted
1 day ago
Salary
0
Seniority
Entry Level
No structured requirement data.
Job Description
Specialty Navigator I
UnitedHealth Group
Specialty Navigator I Location: Norwood United States Hybrid Requisition number: 2339107 Job category: Medical & Clinical Operations Overtime status: Non-exempt Travel: No Job Description: Specialty Navigator I at UnitedHealth Group Skip to main content The UnitedHealth Group Careers website will be undergoing planned maintenance. There will be downtime on Friday March 27th 500 PM Central - Saturday March 28th 500 PM Central. 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Connecting. Growing together. With these values to guide us our people are committed to making a meaningful difference in the lives of those we are honored to serve. Integrity Compassion Inclusion Relationships Innovation Performance Specialty Navigator I Requisition number 2339107 Job category Medical & Clinical Operations Primary location Norwood MA Date posted 03172026 Overtime status Non-exempt Travel No Optum is a global organization that delivers care aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care pharmacy benefits data and resources they need to feel their best. Here you will find a culture guided by inclusion talented peers comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Reporting to and working under the general direction of the Supervisors and Manager of the department the Specialty Navigator I process referrals and authorizations for Atrius Health patients. Receives inbound requests calls emails faxes etc. as well as from within the work queues. Maintains patient records and continually provides information to patients and specialists. Schedule FT 40 hours. Monday - Friday 830am - 5pm. This is a hybrid role - hybrid schedule to be determined by manager upon hire. Location 1177 BOSTON PROVIDENCE HWY NORWOOD MA 02062 If you live near NORWOOD MA you will enjoy the flexibility of a hybrid-remote role as you take on some tough challenges. Primary Responsibilities Manage the referral process processing incoming and outgoing referrals and prior authorizations including intake notification and census roles Handle resolution inquiries from members and/or providers. This is high volume customer service environment. Youll need to be efficient productive and thoroughly dealing with our members over the phone Answers and replies to a large volume of telephone calls faxes and internet queries utilizing and adhering to department scripts and guidelines Reviews patient record. If referral does not already exist obtain authorization from payer enter information into EPIC. Forwards authorization to specialists office Keeps patient and facility informed of status referrals updates and process Obtains authorization from payer websites efficiently and effectively. Keeps log in and credentials Research questions and concerns from patients assists in resolving any issues as they relate to the referral process Escalates difficult issues problems etc. to higher level coordinators or supervisory staff Works with team to ensure timely process of referrals. Participates in team problem solving activities focusing on production and quality Customer Service Ability to provide a high level of customer service to patients visitors staff and external customers in a professional service-oriented respectful manner using skills in active listening and problem solving. Ability to remain calm in stressful situations Written Communications Ability to summarize and communicate in English moderately complex information in varies written formats to internal and external customers Oral Communications Ability to comprehend and communicate complex verbal information in English to medical center staff patients families and external customers Teamwork Ability to work collaboratively in small teams to improve the operations of immediate work group by offering ideas identifying issues and respecting team members Accesses only the minimum necessary protected health information PHI for the performance of job duties. Actively protects the confidentiality and privacy of all protected health information they access in all its forms written verbal and electronic etc. taking reasonable precautions to prohibit unauthorized access. Comply with all Atrius Health and departmental privacy policies procedures and protocols. Follows HIPAA privacy guidelines without deviation when handling protected health information Performs other duties as assigned What are the reasons to consider working for UnitedHealth Group Put it all together - competitive base pay a full and comprehensive benefit program performance rewards and a management team who demonstrates their commitment to your success. Some of our offerings include Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays Medical Plan options along with participation in a Health Spending Account or a Health Saving account Dental Vision Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage 401k Savings Plan Employee Stock Purchase Plan Education Reimbursement Employee Discounts Employee Assistance Program Employee Referral Bonus Program Voluntary Benefits pet insurance legal insurance LTC Insurance etc. Youll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications High School Diploma/GED or higher 1 years of customer service experience preferably in a healthcare setting Intermediate level of proficiency with creating editing saving and sending documents utilizing Microsoft Word and Excel Intermediate level of proficiency with typing and talking at the same time and navigating through multiple screens Preferred Qualifications Experience working within the healthcare industry and with healthcare insurance Experience working in a metric-driven work environment Call center experience A clerical or administrative support background Knowledge of ICD-9 and CPT codes Soft Skills Independence of Action Ability to follow precedents and procedures. May set priorities and organize work within general guidelines. Seek assistance when confronted with difficult and/or unpredictable situations. Work progress is monitored by supervisor/manager Knowledge Ability to demonstrate full working knowledge of standard concepts practices procedures and policies with the ability to use them in varied situations All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets education work experience certifications etc. In addition to your salary we offer benefits such as a comprehensive benefits package incentive and recognition programs equity stock purchase and 401k contribution all benefits are subject to eligibility
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