Employer: UnitedHealth Group
Collections Representative is responsible for the accurate and timely response to denials received. Researching and resolving denials from upstream issues through receiving payment on the claim. Ability to work through various scenarios independently.
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 8:00am – 5:00pm. It may be necessary, given the business need, to work occasional overtime.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
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
Required Qualifications:
- High School Diploma / GED (or higher)
- Knowledge of explanation of benefits (EOB)
- Knowledge of CPT, ICD-10, and HCPCPS coding
- Billing and Collection experience
- Knowledge of benefits verification and prior authorization
- Ability to work any of our 8-hour shift schedules during our normal business hours of 8:00am – 5:00pm. It may be necessary, given the business need, to work occasional overtime
Preferred Qualifications:
- Experience in Microsoft Excel (create and edit spreadsheets)
- Experience in Microsoft Word (creating, editing, saving, formatting)
- Home Infusion Experience
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
Soft Skill:
- Strong organizational skills