Sr. Collector Representative

For those who want to invent the future of health care, here’s your opportunity. We’re going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.

 

The Sr. Collector Rep is responsible for performing complex or specialized collection activities.  Position in this function contact customers and health care insurances to determine reason for payment delinquency, negotiate and advise on collection of overdue bills, take appropriate action to recover overdue payments, and handles unresolved inquiries/issues. The Sr. Collector Rep may assist in developing, implementing, maintaining, and managing organization policies on collections practices.  May work outside legal counsel and/or outside agencies in more complex collection cases.

 

Primary Responsibilities:

• Communicate with and prepare reports for internal partners (e.g., client management, controllers, manager) to inform them of next steps regarding outstanding or past due balances
• Evaluate current collections processes and procedures to identify opportunities for improvement
• Educate relevant internal and/or external stakeholders (e.g., patients, administrators, cash posters, physicians, collectors) regarding collection activities and procedures
• Evaluate account information (e.g., number of invoices; date past due; previous payment history; type of product; different contact; billing addresses) to determine payment issues, root causes, and trends
• Identify account issues that need to be escalated to senior leadership or internal partners for resolution (e.g., system, credentialing, and claim formatting issues)
• Gather/seek additional information from applicable systems to further investigate customers’ concerns or complaints
• Ability to monitor daily workload and create work assignment for the team as needed
• Act as a resource for others
• Record correspondence information (e.g., dates, action taken) within relevant PM systems (e.g., eClinical Works, Allscripts, Athena)
• Receive/make phone calls to customers using relevant systems (e.g., Unity, Anywhere Connect) to request payment for services
• Communicate (e.g., emails, phone calls, written correspondence) potential solutions or available services to external customers
• Performs necessary follow-up to ensure timely resolution of appeals, obtain updated insurance information, identify and correct billing errors, etc
• Receive and/or process credit card payments and/or electronic funds transfers within applicable systems (e.g.,  Velocity)
• Transfer payment information to internal partners (e.g., Cash Posting Dept) to ensure payment is applied to customer accounts
• Receive customer requests for negotiated payment plan/process
• Seek approval from appropriate stakeholders (e.g., management) to negotiate balance payoff and/or payment terms in excess of stated level of authority and guideline limits
• Performs necessary follow-up to ensure timely resolution of appeals, obtain updated insurance information, identify, and correct billing errors, etc
• Perform collection activities on assigned work files (health care insurance and/or patients) according to department procedures
• Create and distribute correspondence to customers (e.g., emails, dunning letters, system-generated letters, invoices) to inform them of needed actions (e.g., reminder of payments due, final demand for payments)
• Manage delinquency suppressions for external customers to send accurate notifications and correspondence
• Maintain current working knowledge of CPT and ICD-10 codes, required modifiers and encounter data
• Maintains up-to-date information on Medicare and Medicaid laws, HCFA requirements, contractual arrangements, and other third-party payer requirements
• Apply knowledge of third-party payer guidelines in reviewing denied claims to ensure appropriate use of modifiers and CPT/ICD-10 codes
• Demonstrate understanding of relevant software applications (e.g., Excel, Outlook, Access, Word)
• Uses, protects, and discloses patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
• Perform additional duties as assigned
• Meets department productivity standards

 

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, G.E.D., or equivalent
• 2+ years of medical collections experience
• CPT and ICD-10 experience
• Experience in utilizing payer web portals
• Computer literate
• Knowledge of practice management and office automation software
• Ability to use 10-key by touch
• Microsoft Office skills, specifically Excel
• Demonstrated excellent verbal and written communication skills

 

Preferred Qualifications:

• CPC, CCS, CMC, CPC-A or CCA Certification 
• Experience in the following PM systems: Allscripts, eCW, and/or Athena 
• Experience in medical collections and self-pay collections
• Previous computer experience (MSWord or other processing programs) 
• HMO/managed care, Fee for Service plans, and/or Medicare experience 

 

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: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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. 

 

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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