Referral Coordinator

Posted Yesterday
Be an Early Applicant
Irvine, CA, USA
In-Office
16-29 Hourly
Junior
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
The Role
Manages member and provider referral intake, admission and discharge information, service requests, and incoming and outgoing cases. Coordinates with hospitals, clinics, facilities, and clinical teams while performing non-clinical triage, outreach, submissions, notifications, and issue resolution. The role operates in a high-volume customer service environment and requires knowledge of medical coding, insurance-related care coordination, and referral processing.
Summary Generated by Built In
Requisition Number: 2382654
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. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
Schedule: This position is full-time, Monday - Friday. Employees are required to work during our normal business hours of 8:00am - 5:00pm; Occasional evening coverage may be required.
This is high volume, customer service environment. You'll need to be efficient, productive and thorough in dealing with our members over the phone. You also must be able to occasionally work a flexible schedule that may include evening hours/weekends as business needs.
If you reside in California, you'll enjoy the flexibility to telecommute* as you take on some tough challenges.
Primary Responsibilities:
  • Manage the intake of members or the admission/discharge information post notification
  • Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providers
  • Manage the referral process, processing incoming and outgoing cases, including intake, notification etc.
  • Provide appropriate Triage, Outreach, Submission and other process steps for non-clinical process
  • Handle resolution/inquiries from members and/or providers

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
  • 1+ years of customer service experience analyzing and solving customer problems
  • 1+ years of experience processing medical referrals, authorizations, or insurance related (non-clinical) care coordination
  • Basic level of proficiency with Microsoft Office
  • Working knowledge with ICD 9/10 and CPT codes

Preferred Qualifications:
  • Experience working within the health care Industry and with health care insurance
  • Experience working with Medicare and/or Medicaid Services
  • Experience with customer outreach in a call center, as a medical assistant, or similar
  • Clerical or administrative support background
  • Strong communication, problem-solving, and de-escalation skills
  • Ability to manage multiple work queues and prioritize tasks in a fast-paced, high-volume environment
  • Bilingual fluency in English and Spanish (verbal and written)

All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
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 $16.00 to $29.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
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.
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.
#RPO #GREEN

Skills Required

  • High School Diploma or GED
  • At least 1 year of customer service experience analyzing and solving customer problems
  • At least 1 year of experience processing medical referrals, authorizations, or insurance-related non-clinical care coordination
  • Basic proficiency with Microsoft Office
  • Working knowledge of ICD-9/10 and CPT codes
  • Experience working in the healthcare industry and with health insurance
  • Experience working with Medicare and/or Medicaid services
  • Experience with customer outreach in a call center, as a medical assistant, or similar role
  • Clerical or administrative support background
  • Strong communication, problem-solving, and de-escalation skills
  • Ability to manage multiple work queues and prioritize tasks in a fast-paced, high-volume environment
  • Bilingual fluency in English and Spanish, verbal and written

What the Team is Saying

Optum Compensation & Benefits Highlights

  • Parental & Family Support Paid parental leave (six weeks), paid caregiver leave (up to two weeks), Bright Horizons back-up care, and adoption assistance up to $10,000 are prominently included. Feedback suggests these family supports meaningfully aid work-life balance and are often highlighted as strengths.
  • Retirement Support A 401(k) with company match is available to all employees, including part-time staff, alongside other financial protections like disability and life insurance. Feedback suggests broad access and matching make retirement support a core pillar of the package.
  • Equity Value & Accessibility An Employee Stock Purchase Plan offers discounted company stock, with some roles also eligible for sign-on or performance bonuses. Feedback suggests the ESPP is a standout financial perk that helps employees build ownership over time.

Optum Insights

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The Company
HQ: Eden Prairie, MN
160,000 Employees
Year Founded: 2011

What We Do

Optum, part of the UnitedHealth Group family of businesses, 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. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. At Optum, we support your well-being with an understanding team, extensive benefits and rewarding opportunities. By joining us, you’ll have the resources to drive system transformation while we help you take care of your future. We recognize the power of connection to drive change, improve efficiency and make a difference in health care. Join a team where your skills and ideas can make an impact and where collaboration is key to creating technology that produces healthier outcomes.

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Optum Offices

Hybrid Workspace

Employees engage in a combination of remote and on-site work.

Optum has three workplace models that balance the needs of the business and the responsibilities of each role. These models, core on‑site (5 days/week), hybrid (4 days/week) and telecommute or fully remote, vary by country, role and location.

Typical time on-site: Not Specified
HQEden Prairie, MN
Metro Manila, Philippines
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Baltimore, MD
Bengaluru, India
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Madison, WI
Minneapolis, MN
Nashville, TN
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Philadelphia, PA
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Washington, DC
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