Process Associate

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.

We are looking for an immediate joiner who should have relevant exposure to Investigations Process with evidence gathering through fact finding and analysis.

Primary Responsibilities:

• Manage administrative intake of members
• Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providers
• Process incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles
• Assist the clinical staff with setting up documents/triage cases for Clinical Coverage Review
• Handle resolution/inquiries from members and/or providers
• Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regard to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so

This is high volume, customer service environment. You'll need to be efficient, productive and thorough dealing with our members over the phone. You also must be able to work a flexible schedule that includes evening hours.

Required Qualifications:

• Any other undergraduates or Postgraduates can apply (Except Medical Science and Life Science graduates)
• Knowledge of (HIPAA) laws pertaining to confidentiality of protected health information
• Demonstrated ability to identify documentation and medical record form(s) and make independent decisions within the scope of one's job responsibilities
• Demonstrated ability to work in a team environment and to collaborate with a variety of professionals
• Demonstrated ability to work occasional off-hours schedules as required
• Proven extremely well versed with MS Office tools (Excel, Word and PowerPoint)
• Proven good data analytical skills combined with excellent communication skills
• Proven detail oriented and ability to be self-motivated to complete duties in a timely manner
• Proven attention to detail with solid organizational skills
• Proven basic analytical skills

Preferred Qualification:

• Experience in healthcare domain

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