Health Advocate

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. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work.(sm)

Optum’s Pacific West region is redefining health care with a focus on health equity, affordability, quality, and convenience. From California, to Oregon and Washington, we are focused on helping more than 2.5 million patients live healthier lives and helping the health system work better for everyone. At Optum Pacific West, we care. We care for our team members, our patients, and our communities. Join our culture of caring and make a positive and lasting impact on health care for millions.

Role Description

The Patient Service Advisor is responsible for developing and conducting patient orientation in a friendly and informative manner. The Advisor is primarily responsible for the processing, recording, and the accuracy of patient billings, and is the local source of assistance when patients have billing questions. This position will work with Marketing to make the community aware of EPIC/Beaver offerings. Familiar with all systems and work flows provided within the Center. Ability to develop correspondence and create patient notification. Participate in a team environment that includes open communication, trust, accountability, and mutual respect.

If you are located within Los Angeles area ONLY, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

• Review clinic policies regarding hours, appointments, prescription renewals, etc.
• Hand out new patient packets when patient is directed to your office and go over contents
• Assist patients in finding a primary care physician, both new and transfers
• Document all transfer on designated log
• Answer questions from patients that are sent via e-mail
• Answer questions from patients regarding their insurance Explanation of Benefits or denials
• Explain and resolve (when possible) patients’ questions and/or concerns about their statements
• When appropriate, initiate an error correction in order to resubmit an insurance claim
• Initiate PPO authorizations for various procedures via the web, fax or phone
• Collect monies from patients for outstanding balances
• Arrange for payment plans
• Counsel patient on Hardship requirements, hand-out paperwork for submittal to PFS
• Print ledgers for patients, when requested
• Request refunds for overpayments to PFS
• Refer all accounts that have questions regarding collection accounts to PFS
• Refer Quest coding inquiries to appropriate nursing staff
• Verify eligibility and check benefits
• Notify PFS to re-bill charges when eligibility is termed
• Book basic appointments, when necessary
• Answer patient questions regarding DNKA letters or Withdrawal of Care Letters
• Handle pregnancy terminations for HMO patients
• Look-up authorizations in Health Access for the patients
• Collect for HMO non-covered services
• Review MSR report
• Review the Credit Manager’s report to see patients with appointments who have outstanding balances
• Review and collect balances, including copayments and outstanding balances
• Provide charge estimates for OB and surgical services prior to patient receiving servicesand arrange for payment
• Patient Concerns
• Review Patients Confidentiality & HIPPA Guidelines with new patients

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 or equivalent
• 1+ years in a Patient Financial Services Department or as a Patient Accounts Representative, or 2+ years as a Support Clerk II, Registration Coordinator, HMO Coordinator, or Appointments Coordinator, or other experience in Registration, Referral Process, PPO Authorizations, or Marketing

Preferred Qualifications:

• AA degree in Business Administration, Accounting or Finance
• 2+ years as a Patient Service Advisor

Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

California Residents Only: The hourly range for California residents is $18.80 to $36.78. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

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.



Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

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