Healthcare Representative

Healthcare Representative

Opportunities at Northern Light Health, in strategic partnership with Optum. Whether you are looking for a role in a clinical setting or supporting those who provide care, we have opportunities for you to make a difference in the lives of those we serve. As a statewide health care system in Maine, we work to personalize and streamline health care for our communities. If the place for you is at a large medical center, a rural community practice or home care, you will find it here. Join our compassionate culture, enjoy meaningful benefits and discover the meaning behind: Caring. Connecting. Growing together.

As a Healthcare Representative, you will interview and advocate for patients and their families to obtain maximum benefit coverage in a hospital or healthcare setting.

This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 4:30 pm EST. It may be necessary, given the business need, to work occasional overtime.

We offer 4 weeks of on-the-job training. The hours of training will be aligned with your schedule.

Primary Responsibilities:

• Interview patients in a hospital setting and work effectively with hospital personnel to assist patients with obtaining maximum benefit coverage
• Complete applications for state and federal programs (including Health Exchange/Marketplace programs)
• Review medical records and take all necessary actions to expedite benefit approval
• Adhere to company and legal standards regarding Protected Health Information (PHI), Personal Identifiable Information (PII) and Personnel Transaction Identifier (PTI)
• Maintain ongoing communication with government agencies regarding the status of claims
• Provide updates and assistance to hospital personnel and other Optum staff as needed
• Maintain documentation of status of claims and client contract on Optum and/or hospital computer systems
• Determine when to use a Federal, State or Local program application based upon medical definition of disability as it relates to body systems and to functions of daily living, and information contained in medical records.
• Willing to work in a fast-paced hospital or healthcare environment

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 equivalent experience
• Must be 18 years of age OR older
• 1+ year of customer service experience in healthcare, government (state or federal), social services, or human services settings
• Experience with Microsoft Office products
• Ability to work on site at 140 Academy Street, Presque Isle, Maine
• Ability to work Monday - Friday, 8:00 am - 4:30 pm EST
• Full Flu vaccination are an essential job function of this role. Candidates located in states that mandate Flu booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation.

Preferred Qualifications:

• Experience communicating with patients & staff with various educational & socio-economic backgrounds
• Knowledge of medical terminology
• Knowledge of federal and state programs that will benefit coverage for clients
• Bilingual fluency in English and Spanish

Physical and Work Environment:

• General office demands
• Prolonged periods of standing and walking in hospital facilities
• Adherence to facility masking requirements at all times

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 $16.15 - $28.80 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

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.