Opportunities at Optum, in strategic partnership with Allina Health. As an Optum employee, you will provide support to the Allina Health account. 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.
This position oversees the follow-up and denial process for Medicaid, PMAP, ChampVA/Tricare and VA payers. Additionally, this department works all out of state MA accounts (OOSMA) as well as specialty accounts such as but not limited to, cosmetic accounts, risk management accounts, fraud accounts, etc.
Hours:
This position is full time (40 hours per week) Monday - Friday
Ability to work Monday - Friday 6:00 a.m. - 6:00 p.m
Ability to train for the first six weeks Monday - Friday, 07:00AM - 04:30PM CST
Flexible Schedule is available after the training period within business hours of Monday - Friday 6:00 a.m. - 6:00 p.m. CST
Telecommuting Requirements: Fully Remote
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
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Hospital or facility insurance billing follow up in compliance with government rules and regulations
Submits, processes, and resolves claim rejections and denials
Verifies patient insurance eligibility for denial resolution
Completes the appeal process
Monitors and follows up on unpaid balances
Resolves issues and resubmits for payment
Utilizes resources to reconcile accounts
Performs demographic and insurance coverage updates on accounts and bills new insurance
Contacts insurance companies to obtain the status of outstanding claims and submitted appeals
Provides professional billing support
Assists in training and mentoring to ensure compliance of established processes
Provides education or feedback to operational sites and other departments within Revenue Cycle Management (RCM)
Participates in process improvement initiatives to improve efficiencies and customer service expectations
Monitors, identifies, and communicates trend analysis
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:
2+ years of experience in revenue cycle operations
2+ years of experience in medical accounts receivable; for example, with government payers (i.e. Medicaid, PMAP's, VA, ChampVA, Tricare, etc.)
Experience with medically unlikely edits, Outpatient Code Editor, UB Billing Editor, Change Healthcare (Assurance), EPIC Claim edits, etc
Experience with Excellian/EPIC Hyperspace billing system
Proficient with Microsoft applications (Word, Excel, Outlook, and Teams)
Preferred Qualifications:
2+ years of experience with medical terminology and medical coding
1+ years of experience in billing follow up and denials
Experience with Change Healthcare Assurance Reimbursement Management claims system
*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.
RPO