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.
As a Major Medical Collections Representative your primary function will be major medical insurance collections. You will be contacting payers regarding outstanding accounts receivables. Handling unresolved inquiries/issues. Responsible for adhering to collections process and maintaining and organization policies on collection practices.
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 7:30am - 6:00pm CST. It may be necessary, given the business need, to work occasional overtime.
We offer on-the-job paid training. The hours of training will be based on your schedule or will be discussed on your first day of employment.
You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Analyzes daily denial management correspondence to appropriately resolve issues
Reviews and resolves accounts assigned via work lists daily as directed by supervisor
Ability to communicate effectively in written and oral form
Ability to multitask and function in a fast-paced environment
Ability to prioritize and problem-solve
Research root cause to report to Supervisor
Identify payer performance trends at the payer level
Capable of navigating payer portal
Identifies bad debt write-offs and adjustments
Process refunds as identified to meet payer guidelines
Adheres to regulatory/payer guidelines and policies and procedures
Provides exceptional customer service to internal and external customers
Other duties as assigned
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
Must be 18 years of age OR older
6+ months of major medical billing OR collection experience
Knowledge of explanation of benefits (EOB)
Knowledge of CPT, ICD-10, and HCPCPS coding
Computer skills, including working knowledge of Microsoft Windows and navigation, mouse and keyboarding skills
Ability to work any of our 8-hour shift schedules during our normal business hours of 7:30am - 6:00pm CST, including the flexibility to work occasional overtime, based on the business need
Preferred Qualifications:
1+ years of experience in a related environment (i.e., office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools
Home Infusion experience
Experience with Microsoft Excel (create and edit spreadsheets)
Experience with Microsoft Word (creating, editing, saving and formatting)
Knowledge of benefits verification and prior authorization
Telecommuting Requirements:
Ability to keep all company sensitive documents secure (if applicable)
Required to have a dedicated work area established that is separated from other living areas and provides information privacy
Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
Soft Skills:
Must be organized and able to prioritize, plan, and handle multiple tasks / demands simultaneously
Ability to verbally articulate and communicate with manager, team members, and customers
Written and oral communications skills
Critical thinking skills
Organizational skills
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
The hourly range for this role is $16.88 to $33.22 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
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.
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.
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