- Bachelor's Degree
- High School Diploma or GED
- Pharmacy Technician Certification
- Microsoft Word
- Pharmacy Technician Experience
Energize your career with one of Healthcare’s fastest growing companies.
You dream of a great career with a great company – where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it’s a dream that definitely can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.
This opportunity is with one of our most exciting business areas: Optum – a growing part of our family of companies that make UnitedHealth Group a Fortune 5 leader.
Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.
Working in Operations at OptumRx is one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.SM
Position in this function are responsible for the installation of assigned accounts, including, but not limited to: structure building and billing set up, structure revisions, researching & resolving structure issues, database loading, and preparation of plan materials such as administrative documents and customer education materials. Positions are responsible for overall employer contract loading using various databases and/or source documents. May research installation issues & develop customer specific resolutions. May include auditing contract loads for adherence to quality measures and reporting standards.
Audit contract loads for adherence to quality measures and reporting standards
Research errors by comparing Account Management documentation against multiple internal systems
Analytical and Researching techniques to trend or quantify projects
Prepare, process, and maintain new group installation and renewals
Respond to member eligibility or group questions and verify enrollment status
Reconcile reports and group set up discrepancies, as well as analyzing transactional data and submitting retroactive eligibility changes
Research and respond to all claims processing inquiries from Client Management, Clinical, and other internal departments
Perform claim testing to ensure accurate claim adjudication
Conduct installation of assigned accounts, including, but not limited to: structure building and billing set up, structure revisions, researching and resolving structure issues, database loading, and preparation of plan materials such as administrative documents and customer education material
Overall employer contract loading using various databases and / or source documents. May research installation issues and develop customer specific resolutions which may include auditing contract loads for adherence to quality measures and reporting standards
Perform other duties as assigned
Basic, structured, standard approach to work
High School Diploma / GED (or higher)
1+ years PBM experience
Experience using Microsoft Excel to create and edit spreadsheets
Bachelor's Degree (or higher)
Certified Pharmacy Technician
RxClaim Software experience
Experience using Microsoft Word to create and edit documents
Physical Requirements and Work Environment:
Frequent speaking, listening using a headset, sitting, use of hands / fingers across keyboard or mouse, handling other objects, and long periods working at a computer
Service center environment with moderate noise level due to Representatives talking, computers, printers and floor activity
OptumRx is an empowering place for people with the flexibility to help create change. Innovation is part of the job description. And passion for improving the lives of our customers is a motivating factor in everything we do.
If you're ready to talk about groundbreaking interactions, let's talk about what happens when a firm that touches millions of lives decides to gather results from millions of prescriptions every month and analyze their impact. Let's talk about smart, motivated teams. Let's talk about more effective and affordable healthcare solutions. This is caring. This is great chemistry. This is the way to make a difference. We're doing all this, and more, through a greater dedication to our shared values of integrity, compassion, relationships, innovation and performance. Join us and start doing your life’s best work.
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.