Payer Analyst – Remote in Chappaqua, NY

Número de la requisición: 2267746
Categoría de la vacante: Claims
Localização da vaga: Chappaqua, NY
(Remote considered)

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. 
  
Responsible for the auditing, monitoring and modification of claims utilizing pre-billing claim edits and clearing house rejections.  As well as collaborating with other departments to modify workflows to ensure the submission of clean claims.  May include providing feedback to RCM vendor and Operations management when data in billing system is entered with errors by staff.  Ensure adherence to state and federal compliance billing policies and practices.
  
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 8:00 am – 4:30 pm. It may be necessary, given the business need, to work occasional overtime. Our office is located at CHAPPAQUA-480 BEDFORD RD.
  
We offer 4 weeks of hybrid on-the-job training. The hours of training will be aligned with your schedule.
  
If you are located within commutable distance to CHAPPAQUA-480 BEDFORD RD.,  CHAPPAQUA, NY, you will have the flexibility to work remotely* as you take on some tough challenges. 
  
  
Primary Responsibilities
  • The Payer Analyst will support short and long term operational and strategic business activities by managing and maintaining pre-AR claim data.
  • This individual will gather required data for the creation of Excel workbooks and pivot tables to be shared with the Revenue Cycle Management team. 
  • Supports the assignment of pre-AR claim responsibilities for the Revenue Cycle Management Vendor.
  • Engages in analyzing data and reporting projects by gathering required data and sharing reports with the applicable Revenue Cycle Management departments.
  • Daily review, correction and submission of claims identified in the clearing house rejections.
  • Analyze claim edits and clearing house rejections to identify rules for addition to the automated claim scrubber engine to improve efficiencies.
  • Collaborate with stakeholders to understand business objectives and requirements.
  • Partners with cross-functional teams to implement process improvements and enhance operational efficiency.
  • Perform error corrections on charges and payments in the billing system as needed.
  • Execute insurance eligibility review utilizing online portals or telephone communication.
  • Modify demographic and insurance information in billing system as needed.
  • Participate in bi-weekly calls with RCM vendor to review and resolve pre-billing claim edit and clearing house rejections.

    

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 Qualification

  • High School Diploma/GED
  • 18 years or older
  • 4+ years healthcare revenue cycle management experience 
  • Knowledge of medical terminology and procedures, medical coding (ICD-9, ICD-10, HCPS) and insurance processes.
  • Intermediate experience using Excel 
  • Expectation of confidentiality on all business matters.
  • Ability to work Monday – Friday 8:00 am -4:30 pm

  

Preferred Qualification 

  • Epic experience

  

Telecommuting Requirements

  • Reside within commutable distance to CHAPPAQUA-480 BEDFORD RD.,  CHAPPAQUA, NY
  • 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 

  • Ability to multi-task, this includes ability to understand multiple workflows to work efficiently.

  

  *All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

  

The hourly range for this role is $16.88 to $33.22 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.

  

  

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

  

UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.

  

#RPO

Información adicional sobre la vacante

Número de la requisición 2267746

Segmento de negocio Optum

Nivel del cargo Individual Contributor

Disponibilidad para viajar No

País US

Estado de horas extras Non-exempt

Vacante de teletrabajo Yes