UnitedHealth Group
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
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. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life’s best work.
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 7:00am – 5:00pm CST. It may be necessary, given the business need, to work occasional overtime and/or weekends.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Primary Responsibilities:
- Review open AR and prioritize pharmacy claim activities
- Develop relationships with payers to obtain claim requirements and resolve root causes
- Assure that timely and accurate follow up activity is performed on all pharmacy claims that are not paid within 45 days of submission
- Responsible for review and documenting of key accounts
- Identify issues/trends and escalate to Supervisor/Manager when assistance is needed.
- Develop relationships with other departments to provide feedback about root cause issues
- Provides exceptional customer service to internal and external customers
- Process payments, adjustments, refunds, and transfer payments
- Research, troubleshoot and resolve complex billing issues and customer complaints, taking all steps to resolve and ensure full resolution
- Obtain agreement and potential balance payoff and/or payment terms within stated level of authority and guideline limits
- 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 (or higher)
- 1+ years of basic level experience in Microsoft Excel (opening a workbook, inserting a row, selecting font style and size)
- 1+ years of basic level experience in Microsoft Outlook (creating and replying to emails)
- Ability to work an 8-hour shift during normal business hours between 7:00 am -5:00pm Central Standard Time, Monday – Friday
Preferred Qualifications:
- Specialty Pharmacy experience
- Knowledge of billing / finance and eligibility processes, practices, and concepts
Telecommuting Requirements:
- Required to have a dedicated work area established that is separated from other living areas and provides information privacy
- Ability to keep all company sensitive documents secure (if applicable)
- Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
California, Colorado, Connecticut, Nevada, Washington or New York City Residents Only: The salary range for California / Colorado / Connecticut / Nevada / Washington / New York City residents is $16.00 – $31.44.Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.