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.
This position is full-time. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:30am – 4:00pm PST, Monday – Friday. It may be necessary, given the business need, to work occasional overtime.
We offer 6 weeks of on-the-job training. The hours during training will be an 8-hour shift between 7:30am to 4:00pm PST, Monday – Friday.
If you are located in Central, Mountain, or Pacific Time Zones, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:
- 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.
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 hospital collections experience, where collections was done directly for the hospital/facility
- 1+ years of appeals and denied claims experience for a Hospital/facility
- Experience navigating within an insurance portal to work denied hospital claims to resolution
- Proficient in Microsoft Office Suite – including Word, Excel, and Outlook
- Ability to train for the first six weeks from, Monday – Friday, 07:00AM – 04:00PM PST
- Ability to work any of our 8-hour shift schedules during our normal business hours of 7:30am – 4:00pm PST, Monday – Friday. It may be necessary, given the business need, to work occasional overtime
Preferred Qualifications:
- 2+ years of experience working in an inbound/outbound call center environment
- Knowledge of or experience using Claims Administrator billing platform
- Experience processing denials and submitting appeals
Telecommuting Requirements:
- Reside within Central, Mountain, or Pacific Time Zones
- 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
- If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group – approved symptom screener. When in a UnitedHealth Group building
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy