Collections Representative

This position is National Remote. 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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization 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 8:00am – 4:30pm EST. It may be necessary, given the business need, to work occasional overtime.

We offer 4 weeks of on-the-job training. The hours of training will be aligned with your schedule.

 

Primary Responsibilities:

• Reviews medical record documentation to identify services provided by physicians and mid-level providers as it pertains to claims that are being filed
• Verifies appropriate CPT, ICD, and HCPCS codes to accurately file claims for the physician service using the medical record as supporting documentation
• Performs corrections for patient registration information that includes, but is not limited to, patient demographics and insurance information
• Responsible for working EDI claim rejections in a timely manner
• Receives and interprets Explanation of Benefits (EOB) that supports payments from Insurance Carriers, Medicare, or patients. Able to apply correctly to claims/ fee billed
• Processes incoming EOBs to ensure timely insurance filing or patient billing. May require correction of data originally submitted for a claim or Coordination of Benefits with secondary insurance
• Responsible for reviewing payments, adjustments and denials according to established guidelines
• Responsible for reviewing insurance payer reimbursements for correct contractual allowable amounts
• Responsible for reconciling transactions to ensure that payments are balanced
• Responsible for reducing accounts receivables by accurately and thoroughly working assigned accounts in accordance with established policy and procedures
• Responsible for keeping current with changes in their respective payer’s policies and procedures
• Communicates with the insurance payer to provide or obtain corrected or additional data
• Prepare documents for training or for establishing procedures for clinics
• Answer patient and customer questions regarding billing and statements
• Performs all other related 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  
• Must be 18 years OR Older
• 2+ years of experience in healthcare collections/follow-up
• 1+ years of experience handling insurance denials and coordinating appeals with insurance companies to resolution
• Experience reading EOB’s (explanation of benefits)
• 1+ years of MS Excel experience (filtering, editing, sorting, saving data to spreadsheets)
• 1+ years of work experience using MS Outlook or similar email system (calendaring, folders, emails)
• Experience working with a PC and multiple programs/systems and the ability to learn new and sometimes complex program
• Ability to work fulltime, Monday – Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am – 4:30pm EST. It may be necessary, given the business need, to work occasional overtime

 

Preferred Qualifications:

• 2+ years of work experience with the following payers: Medicare, Medicaid, Managed Care & Commercial Payers
• 2+ years of experience with submission and resubmission of medical claims
• 1+ year of EPIC experience
• HCFA-1500 billing experience
• Technical skills in the areas of EDI, systems analysis and process flows
• Knowledge of ICD, CPT codes and HCPCS coding
• Knowledge of HIPAA compliance rules and regulations

 

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

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you’ll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.74 – $31.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 

 

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.

 

 

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

 

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