Note: The job is a remote job and is open to candidates in USA. Optum, in partnership with Allina Health, is dedicated to improving health outcomes by connecting individuals with necessary care and resources. The Financial Clearance Representative Associate will be responsible for completing the financial clearance process and ensuring patients understand their financial responsibilities while collaborating with various healthcare staff and insurance payers.
Responsibilities
- Verify insurance eligibility and completes automated insurance eligibility verification, when applicable and appropriately documents information in Epic
- Confirm that a patient's health insurance(s) is active and covers the patient's medication
- Review and analyze patient visit information to determine whether authorization is needed and understands payor specific criteria to appropriately secure authorization and clear the account prior to service where possible
- Ensure that initial and all subsequent authorizations are obtained in a timely manner
- May provide mentoring to less experienced team members on all aspects of the revenue cycle, payer issues, policy issues, or anything that impacts their role
- Initiating prior authorizations for medications
Skills
- High School Diploma/GED (or higher)
- 6+ months of experience with insurance and pharmacy benefit verification, pre-experience with prior authorization activities in healthcare business office/insurance operations
- 6+ months of experience using basic retail medication knowledge
- Intermediate level of proficiency with Microsoft Office products
- Must be 18 years of age OR older
- Associate degree or Vocational degree in Business Administration, Health Care Administration, Public Health, or Related Field of Study
- Experience working with clinical staff
- Previous experience working in outpatient and/or inpatient healthcare settings
- Experience working in clinical documentation
- Previous experience working with a patient's clinical medical record
- Retail pharmacy experience
- EPIC experience
- Payer portals and/or covermymeds experience
- CphT or CMA certification
Benefits
- Comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase
- 401k contribution
Company Overview
Optum is a healthcare company that provides pharmacy services, health care operations, and population health management. It is a sub-organization of UnitedHealth Group. It was founded in 2011, and is headquartered in Eden Prairie, Minnesota, USA, with a workforce of 10001+ employees. Its website is https://www.optum.com/.Company H1B Sponsorship
Optum has a track record of offering H1B sponsorships, with 648 in 2025, 559 in 2024, 620 in 2023, 851 in 2022, 593 in 2021, 438 in 2020. Please note that this does not guarantee sponsorship for this specific role.