Collections Representative – National Remote

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 function is responsible for accurate and timely follow-up of accounts receivables including researching, analyzing, and resolving unpaid specialty pharmacy medical claims. Positions in this function contact payers to determine reason for non-payment and take appropriate action to recover amounts due.  Responsible for developing, implementing, maintaining, and managing organization policies on collection practices.

This position is full-time, Monday – Friday. Employees are required to work an 8 hour shift during our normal business hours of 6:30 am – 5:00 pm CST. It may be necessary, given the business need, to work occasional overtime and weekends. 

We offer 2 weeks of training then on the job training. The hours during the first few weeks of training will be 6:30 AM – 3:00 PM CST and then the on the job training hours will be during 7:00 AM – 5:00 PM CST from Monday – Friday (100% attendance required). Participation on camera may be asked during training. Training will be conducted virtually from your home.

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.  

  

Primary Responsibility:

• Review open AR and prioritize medical 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 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
• Provide exceptional Customer service to internal and external customers
• Develop relationships with other departments to provide feedback about root cause issues
• Adhere to Regulatory / Payer Guidelines and policies & procedures
• 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 OR equivalent work experience
• Must be 18 years of age OR older 
• 1+ years of experience with specialty drug knowledge OR pharmacy / medical claim billing / follow-up OR less than 1 year experience with valid medical billing / coding certificate
• 1+ years of experience with working in Microsoft office suite, specifically Microsoft Word (create, copy, edit, send and save documents), Microsoft Excel (create, copy, edit, send and save spreadsheets) and Microsoft Outlook (create, copy, edit, send and save emails) 
•  Ability to attend training 100% within the hours of 6:30 AM – 3:00 PM CST
• Ability to work any 8-hour shift between 6:30 am – 5:00 pm CST from Monday – Friday

  

Preferred Qualifications:

• Specialty Pharmacy experience
• Knowledge of NDC, ICD-10, and HIPAA
• Intermediate level skill in Microsoft Excel (using filters, sorting, conditional formatting, basic formulas)

  

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 

  

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