Recovery Resolution 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 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 – 5:00 pm EST.  

We offer 4 weeks of paid training during normal business hours.

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

   

Primary Responsibilities:

• Prioritize inventory of selected claims by client to maximize revenue and to balance the financial targets established for 30+ different payer clients
• Communicate (written and verbal), with hospitals to ensure smooth operations for obtaining medical records.
• Build and manage relationships with hospital facilities and staff; use of soft skills and superior communication to leverage these relationships in efforts to smooth the audit operation process.
• Manage selected claims inventory by client to prioritize workload.
• Understand and apply different client rules where appropriate. 
• Conduct follow-up audit activities as needed, including outreach to facilitate the collection of medical records.
• Ability to adjust to changing priorities by management in a face paced environment.
• Update database to reflect current provider contacts.
• Follow HIPAA protocol and minimize misdirection of PHI.
• Work with other teams including clinical team, analyst team, post audit, and account management to solve problems.
• Troubleshoots issues that arise in ChartPoint programs.

 

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+ year of healthcare billing experience
• Moderate proficiency with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
• Ability to work between the hours of 8:00 AM – 5:00 PM EST from Monday – Friday 

 

Preferred Qualifications: 

• 1+ years of experience in claims recovery and resolution
• Experience with working with Microsoft Office 

 

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 

 

Soft Skills:

• Ability to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each product

 

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