Senior Insurance 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.

 

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

 

Primary Responsibilities:

• Analyzes daily denial management correspondence to appropriately resolve issues
• Reviews and resolves professional medical billing claim denials assigned via work lists daily as directed by supervisor
• Ability to communicate effectively in written and oral form
• Ability to multitask and function in a fast-paced environment
• Ability to prioritize and problem-solve
• Research root cause to report to Supervisor
• Identify payer performance trends at the payer level
• Capable of navigating payer portal
• Adheres to regulatory/payer guidelines and policies and procedures
• Provides exceptional customer service to internal and external customers
• 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:

• 3+ years of experience in revenue cycle operations or medical accounts receivable
• Computer skills, including working knowledge of Microsoft Windows and navigation, mouse, and keyboarding skills
• Knowledge of explanation of benefits (EOB)
• Detailed knowledge of CPT, ICD-10, and HCPCPS coding for professional medical billing
• 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

 

Preferred Qualifications:

• Proficiency in Epic
• Knowledge of Government Rules and Regulations as they pertain to claims submission and resolution
• Familiarity with Managed Care, Medicare, PPO, HMO, and other insurance plan types
• Knowledge of payor portals such as Availity, Connex etc.
• Proven ability to analyze and trend and resolve one or more of the following: Underpayment/low payment review, appeal and account resolution for denials related to coding and/or case management, aging accounts receivable that require escalated review for resolution

 

Soft Skills:

• Solid organizational skills
• Excellent written and oral communications skills
• Must be organized and able to prioritize, plan, and handle multiple tasks/demands simultaneously
• Demonstrated critical thinking skills
• Ability to verbally articulate and communicate with manager, team members, and customers

 

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

 

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C., Maryland Residents Only: The hourly range for this role is $19.47 to $38.08 per hour. 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.

 

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.

 

 

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