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. ?
This position is full time, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 5:00pm EST. It may be necessary, given the business need, to work occasional overtime.
We offer 4 weeks of on-the-job training. The hours of training will be aligned with your schedule.
You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
This position performs collecting, reconciliation, research, correspondence, and independent problem solving.
Reconciles complex, multi-payment accounts.
Submits appeal letters on underpaid claims as directed.
Interprets payer contracts to determine if payment and adjustment is accurate.
Reviews EOB's for denials, along with posting corrected adjustments in order to balance accounts.
Identifies needs for process improvements and creating/enhancing processes in the PFS department.
Promotes positive teamwork within department and among employees.
Works with all hospital departments for proper coding and billing procedures.
Follows all departmental, hospital, and regulatory policies and procedures, including HIPAA requirements.
Utilizes top customer service skills with all customers: patients, government agencies and commercial insurances
Reconciles accounts on a daily basis to determine underpayment, overpayment or contractual adjustment correction.
May be assigned to process payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications, and/or payment plans in an accurate and timely manner, meeting goals in work quality and productivity.
Coordinates with other staff members and physician office staff as necessary ensure correct processing.
Reconciles, balances, and pursues account balances and payments, and/or denials, working with payor remits, facility contracts, payor customer service, provider representatives, spreadsheets and the company's collection/self-pay policies to ensure maximum reimbursement.
May be assigned to research payments, denials and/or accounts to determine short/over payments, contract discrepancies, incorrect financial classes, internal/external errors.
Makes appeals and corrections as necessary.
Builds strong working relationships with assigned business units, hospital departments or provider offices.
Identifies trends in payment issues and communicates with internal and external customers as appropriate to educate and correct problems.
Provides assistance to internal clients.
Responds to incoming calls and makes outbound calls as required to resolve billing, payment and accounting issues.
Provides assistance and excellent customer service to patients, patient families, providers, and other internal and external customers.
Works as a member of the patient financial services team to achieve goals in days and dollars of outstanding accounts. Reduces Accounts Receivable balances.
Uses systems to document and to provide statistical data, prepare issues list(s) and to communicate with payors accurately.
Works independently under general supervision, following defined standards and procedures.
Uses critical thinking skills to solve problems and reconcile accounts in a timely manner.
**External customers include all hospital patients, patient families and all third-party payers.
**Internal customers include facility medical records and patient financial services staff, attorneys, and central services staff members.
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 or older.
1+ year experience with healthcare billing and/or collections
Proficient in Microsoft Office Suite - including Microsoft Word, Microsoft Excel, and Microsoft Outlook
Ability to work Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 5:00pm EST. It may be necessary, given the business need, to work occasional overtime.
Preferred Qualifications:
Experience with follow up on Arizona Medicaid claims
Experience working with commercial follow up claims
Tricare VA follow up experience
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.
*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.
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.
