Provide expertise or general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims Analyze and identify trends and provide reports as necessary Consistently meet established productivity, schedule adherence and quality standards This is a challenging role that takes an ability to thoroughly review, analyze and research complex health care claims i

Assist in opening and closing the clinic, locking and unlocking the doors, and maintaining a clean waiting area Welcome all On Site Clinic patients and visitors by greeting them with a friendly demeanor, answering inquiries and directing them through the registration process. Answer multi phone lines, filing, faxing, scanning documentation and completing daily patient callbacks Collect all insuran

Serves as healthcare data analyst for local and national market projects Solves complex problems and develops innovative sustainable solutions Works with customers to define and document additional requirements to enrich reporting capabilities and assists in coordination of user acceptance testing Develops systematic reporting processes and procedures to ensure timely delivery of daily, weekly, mo

Conduct a detailed eligibility verification of insurance benefits Determine coverage, service level co pays, deductibles and outstanding balances Accurately document and maintain insurance and patient demographic information in Practice Management system Exceptional verbal, written and interpersonal communication skills Proven experience with developing positive relationships with physicians, seni

Lead the month end close and reporting function for the new business and present results to senior leadership Working in collaboration with business and functional leadership at both OptumRx and the Optum Specialty and Infusion Pharmacies this position will help develop and build the financial systems to support this new business Build and lead a team of accountants with expertise in revenue recog

Order vaccines as needed Oversight of the medical teams CLIA competences Serve as liaison between patients, staff and providers Support the care team and its patients by providing and documenting nursing care following established standards and practices Provide patient care and education and assist in locating and coordinating services from other providers and resources Serve as liaison between p

Visit Medicaid members in their homes and/or other settings, including community centers, hospitals or providers’ offices Provide a complete continuum of quality care through close communication with members via in person or on phone interaction Support members with condition education, medication reviews and connections to resources such as Home Health Aides or Meals on Wheels Assist

Enter and verifies billing, patient information and other types of data in the computer system Assist in identifying billing & coding errors needing correction for recovery of reimbursement Perform word processing and various other clerical duties for department as assigned Enter and retrieves financial, administrative and patient information Keep files organized, maintain payer correspondence

The Medical Assistant supports the Care team and its patients through patient care, clinical and administrative tasks including patient intake, receiving and responding to patient phone calls, and documenting patient interactions The MA performs duties within their scope of practice delegated by, and under the supervision of, a provider or physician Performs all duties within the scope of a Medica

Establishes work procedures and standards to improve efficiency and effectiveness in the office Assists Senior Practice Manager and physician(s) to develop and implement long range plans Manages office operations to maximize patient access, patient satisfaction, and collection of payments Coordinates staff and provider schedules to ensure proper coverage for quality patient care Manages human reso

Identifies high risk enrollees, monitors utilization, creates care plans to address problems while maintaining quality of care. (Information is collected from MCOs, the patient, caregiver(s), LBHAs and other relevant parties.) Utilizes advanced clinical skills to make effective decisions to meet the enrollee’s health needs, using education, communication, and all available resources to promo

include Suturing Splinting Initial interpretation with digital X Rays Incisions and drainage What makes an OptumCare organization different? Providers are supported to practice at the peak of their license Patients are treated like family. We focus on helping patients get in, get healthy, and get back to what’s really important. We are influencing change on a national scale while still

Deliver the highest quality urgent care services, including Physical examinations Incisions and drainage Splinting Suturing Managing infection and wound care What makes an OptumCare organization different? Providers are supported to practice at the peak of their license We recognize that if you want to provide good care and do it well, you can’t do it alone – this is the foundation of

Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations. Document clinical review findings, actions and outcomes in accordance with policies, and regulatory and accreditation requirements. Engage with requesting providers as needed in peer to peer discussions. Be knowledgeable in interpreting existing b

Assess, screen, triage and perform treatment ordered for patients Perform medical treatment as ordered by provider or established MedExpress standing orders Prepare and assist provider with dispensing prescribed medications (in states where applicable) Assists the provider with examinations, procedures and other duties Oversee and coordinate the daily patient care flow Assist patients as need