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.
The Insurance Follow-Up Representative is responsible for optimizing facility reimbursement by providing financial, administrative, and clerical support related to claims. Responsible for researching claims with no response from the Payer, denials, resolving claims issues and other discrepancies according to established policies and procedures in an efficient, timely and accurate manner. This position is highly focused on the resolution of insurance processing errors and / or denials.
This position is full – time. Employees are required to work any scheduled shift between the hours of 6:00 AM – 6:00 PM CST (Central Standard Time). Training will be conducted virtually from your home.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Primary Responsibilities:
Outstanding Insurance claims resolution 65%
Review, analyze and resolve outstanding and / or denied claims that have been submitted to the payor for reimbursement
Identify, document, and communicate root cause of trends in recurring denials as well as recommend solutions and/or process improvements to prevent future denials
Contact payors regarding billing discrepancies, payment inconsistencies and / or other claim related issues
Research delinquent accounts to successful claim resolution
Document Management 25%
Works incoming correspondence, including Payor letters, denials and additional information requests necessary to process claims
Submits necessary Payor reconsiderations and / or appeals to overturn denials
Interprets explanation of benefits for appropriate follow up action
Other duties as assigned 10%
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 related Insurance Follow-up experience
Knowledge of payer policies and procedures
Ability to adhere to all HIPAA guidelines and regulation including confidentiality
Experience with using Microsoft Office applications, including Microsoft Word and Microsoft Excel
Ability to work any scheduled shift between the hours of 6:00 AM – 6:00 PM CST (Central Standard Time)
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 Skills:
Strong computer skills
Effective in identifying and analyzing problems
Prioritizes workload
Careers with OptumInsight. Information and technology have amazing power to transform the Healthcare industry and improve people’s lives. This is where it’s happening. This is where you’ll help solve the problems that have never been solved. We’re freeing information so it can be used safely and securely wherever it’s needed. We’re creating the very best ideas that can most easily be put into action to help our clients improve the quality of care and lower costs for millions. This is where the best and the brightest work together to make positive change a reality. This is the place to do your life’s best work.SM
California, Colorado, Connecticut, Nevada, Washington, New York, or Rhode Island Residents Only: The salary range for California / Colorado / Connecticut / Nevada / Washington / New York / Rhode Island residents is $16.00 – $27.31. 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.
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.