LHI – Certification Specialist – La Crosse, WI or US Telecommute

UnitedHealth Group
November 16, 2020
San Jose, CA
Job Type


At Optum, the mission is clear: Help people live healthier lives and help make the health system work better for everyone
LHI is one of 4 businesses under OptumServeOptumServe provides health care services and proven expertise to help federal government agencies modernize the U.S. health system and improve the health and well - being of Americans.
By joining OptumServe you are part of the family of companies that make UnitedHealth Group a leader across most major segments in the U.S. health care system.
LHI was founded in 1999 and acquired by Optum in 2011, LHI specializes in creating and managing health care programs through on - location services, patient - specific in - clinic appointments, telehealth assessments, or any combination based on customer need. LHI's customizable solutions serve the diverse needs of commercial customers, as well as federal and state agencies, including the U.S. Departments of Defense, Veterans Affairs, and Health and Human Services.
There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Ready for a new path? Start doing your life's best work.SM 
The LHI Certification Specialist collaborates with the Certification Specialist, RN to complete medical summaries for specific health conditions.  Reviews medical records and cohesively constructs record reviews with Certification Specialist, RN.  Assures all components pertinent to the member needs are addressed in the documentation.
Primary Responsibilities:
  • Communicate with a variety of internal and external individuals for the purpose of acquiring accurate and up - to - date information concerning WTCHP NPN certifications
  • Compile data from a variety of sources for the purpose of preparing WTC NPN Certifications
  • Receive, review, and evaluate various documents for health - related certifications
  • Review records for qualifying information
  • Contact members to obtain information pertinent to certification
  • Navigate codebook to identify qualifying coverage
  • Understand program coverage guidelines
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 higher)
  • 1+ years of experience in a customer service setting
  • Completed Medical, Vocational or Technical training / education and / or completed Clinical Upskilling course
  • Knowledge of Medical Terminology
  • Ability to work an 8 hours shift between 7:00 AM - 6:00 PM CST from Monday - Friday
Preferred Qualifications:
  • Previous call center experience 
  • Ability to travel up to 5% of the time (1 - 2 times for training and seminars within the state)
Soft Skills:
  • Demonstrated ability to adapt to performing a variety of duties, changing from one task to another of a different nature, without a loss of efficiency or composure
  • Must have the ability to take initiative and be detail - orientated in a goal - orientated environment.
  • Excellent verbal and written communication skills including strong telephone etiquette and interpersonal skills with individuals at all levels of an organization
  • Excellent grammar and spelling
Careers with LHI. Our focus is simple. We're innovators in cost - effective health care management. And when you join our team, you'll be a partner in impacting the lives of our customers, and employees. We've joined OptumHealth, part of the UnitedHealth Group family of companies, and our mission is to help the health system work better for everyone. We're located on the banks of the beautiful Mississippi River in La Crosse, Wis., with a satellite office in Chicago and remote employees throughout the United States. We're supported by a national network of more than 25,000 medical and dental providers. Simply put, together we work toward a healthier tomorrow for everyone. Our team members are selected for their dedication and mission - driven focus. For you, that means one incredible team and a singular opportunity to do your life's best work.SM
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.
Keywords: medical documents, medical file review, La Crosse, WI, Optum, WTC NPN Certifications, health related certifications, customer service, medical terminology

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