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 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.
Primary Responsibilities:
- Be able to manage and resolve escalations effectively while maintaining high levels of customer and stakeholder satisfaction
- Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so
Required Qualifications:
- 3+ years of healthcare Revenue Cycle Management (RCM) experience
- 2+ years of experience in Financial Clearance, Insurance Verification, Prior Authorization, or Patient Access
- Experience using EMR/EHR platforms such as Epic, Cerner, Meditech, or comparable systems
- Experience conducting quality audits to ensure accuracy, compliance, and process adherence
- Proven experience in advanced insurance verification, including eligibility validation, benefits review, and coverage determination
- Solid knowledge of prior authorization processes, requirements, and payer guidelines
- Solid understanding of:
- Insurance Verification
- Benefits Investigation
- Prior Authorization
- Medical Necessity Requirements
- Financial Clearance Processes
- Demonstrated solid analytical and problem-solving skills with a focus on process improvement and operational efficiency
- Demonstrated solid verbal and written communication skills
- Demonstrated ability to provide training and mentoring to team members, fostering skill development and performance improvement
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.
Optum is a drug-free workplace. © 2026 Optum Global Solutions (Philippines) Inc. All rights reserved.