Description

Explore opportunities with Atrius Health, part of the Optum family of businesses. We're an innovative health care leader and multi-specialty group practice, delivering an effective, connected system of care for adult and pediatric patients at 28 practice locations in eastern Massachusetts. Our entire team of providers (physicians, PA/NPs and ancillary clinicians) works collaboratively with a value-based philosophy within our group practice as well as with hospitals, rehab and nursing facilities. Be part of our vision to transform care and improve lives by building trust, understanding and shared decision-making with every patient. Join us and discover the meaning behind Caring. Connecting. Growing together.

As a Specialty Navigator I you will report to and work under the general direction of the Supervisor(s) and Manager of the department, process referrals and authorizations for Atrius Health Patients. Maintains patient records and continually provides information to patients and specialists.

Schedule: Monday-Friday; 8:30am-5pm

Primary Responsibilities:

• 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. It referral does not already exist, obtain authorization from payer, enter information into EPIC. Forwards authorization to specialist's office
• Keeps patient and facility informed of status, referrals, updates and process
• Obtains authorizations from payer websites efficiently and effectively. Keeps log in and credentials
• Researches 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

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction 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 equivalency
• 1+ years of experience working in a clinical or customer service position
• Ability to understands nuances to payer systems and escalate issues as needed
• Demonstrated knowledge of a wide range of patient issues for every contracted and non-contracted payers, including government and non-government payers.
• Solid technical proficiency in Microsoft, scheduling software and electronic medical records systems (Epic or equivalent)
• Solid technical proficiency scheduling software and electronic medical records (EPIC or equivalent)
• Proven 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
• Demonstrated ability to make decisions that are guided by general instructions and practices requiring some interpretation. May make recommendations for solving problems of moderate complexity and importance
• Proven ability to follow precedents and procedures

Preferred Qualifications:

• 1+ years of experience working in a health care setting
• Knowledge and understanding of health insurance plans

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 requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $16.00 to $27.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.