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.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.
Within this role as a Collections Representative, your focus will be resolving patient account balances and billing items. Your primary role will be reviewing and resolving member billing inquires and disputes. You will also handle researching member account balances for accuracy and resolve any discrepancies as needed. The team will cross train you in reviewing accounts for correct cash application, contacting insurance companies to obtain payment status or how to have overpayments returned, make necessary judgment calls on adjustments and any other special project as assigned. You will be expected to handle Inbound calling from patients and/or representatives from internal/external departments; Outbound calling to members to collect payment; insurance-copay assistance programs to resolve member account balances.
We are seeking flexible and hands on individuals to fit a growing team! Agents are expected to work a minimum of 12 accounts per day and Quality expectation is a minimum of 98% on audits.
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 8am – 5:30pm CST. It may be necessary, given the business need, to work occasional overtime.
We offer weeks of paid training. The hours of the training will be based on schedule or will be discussed on your first day of employment.
*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
- Answer incoming calls on an inbound phone que from patients or their representative, regarding patient bill balances, payment plans, credit card payment, patient pricing, re-billing insurance companies, copay assistance programs and general customer concerns.
- Process payments, adjustments, refunds, and transfer payments
- Evaluate and respond to email requests regarding patient billing inquires
- Research, troubleshoot and resolve complex billing issues and customer complaints, taking all steps to resolve and ensure full resolution
- Use, email and phones to contact customers to discuss, negotiate payment and resolve outstanding pharmacy accounts and balances
- 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
- Must be 18 years of age or older
- 1+ years of experience with pharmacy claim adjudication or pharmacy claim collections accounts receivable OR 1+ years BriovaRx/Optum Specialty Pharmacy / Drugs experience
- 1+ years experience performing multiple concurrent tasks with strong attention to detail
- 1+ years basic level skills in Microsoft Excel (opening a workbook, inserting a row, selecting font style and size)
- 1+ years basic level skills in Microsoft Outlook (creating and replying to emails)
- 1+ years of experience working in a customer service call center in the healthcare industry
- Ability to work any 8 – hour shift during normal business hours between 8:00am – 5:30pm CST, Monday -Friday
Preferred Qualifications:
- Specialty Pharmacy experience
- Experience working in a customer service call center in the healthcare industry
- Prior customer service experience analyzing and solving customer’s concerns.
- Prior Pharmacy billing experience
- Prior experience working with or billing copay assistance programs.
- Experience in a related environment (i.e., office, call center, customer service, etc.) using phones and computers as the primary job tools
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:
- Proficient with de-escalation
- Exceptional communication skills
- Empathetic customer service skills
- Proficient conflict management skills including the ability to resolve stressful situations
- Demonstrated ability to listen skillfully, collect relevant information, build rapport, and respond to customers in a compassionate manner
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Washington or Rhode Island Residents Only: The hourly range for California / Colorado / Connecticut / Hawaii / Nevada / New York / New Jersey / Washington / Rhode Island residents is $16.54 – $32.55 per hour. 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.