Utilization Management Representative

UnitedHealth Group • San Diego, CA

242d • $16 - $28 • Onsite

About The Position

Explore opportunities at Southern California Physicians Managed Care Services, part of the Optum family of businesses. We're committed to delivering innovative leadership in health care management, continuously improving services for our clients and communities. You can be part of a dedicated team of professionals who provide administrative and financial solutions to support physicians in delivering quality care to patients. Join us and discover the meaning behind Caring. Connecting. Growing together.

Requirements

• High School Diploma / GED OR equivalent years of experience
• Must be 18 years of age OR older
• Experience with working in healthcare environment, physician's office, insurance company
• Knowledge of medical terminology, ICD and CPT coding
• Experience with computers and Windows based programs including Microsoft Word and Microsoft Outlook
• Ability to work any of our 10-hour shift schedules during our normal business hours of 6:30 - 5:00 PM PST. It may be necessary, given the business need, to work occasional overtime.

Nice To Haves

• Experience in working with prior authorizations

Responsibilities

• Performs data entry of prior authorization requests accurately on a daily basis to meet turnaround time standards
• Contacts Health Plans for medical policies or benefit interpretations
• Contacts physician offices as directed by Case Manager to obtain additional clinical information
• Sorts and distributes faxed images into designated folders on a rotating shared sorting schedule
• Other duties as assigned

Benefits

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

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Insurance Carriers and Related Activities
• Education Level: High school or GED