Recovery and Resolution Representative – Brewer, ME

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 role handles information about patient services and how those services are paid by investigating and resolving credit balances through contact with various parties.  The Resolution Representative is responsible for the overall management of an assigned provider client’s credit balance inventory and may manage multiple inventory types at any given time. The Resolution Representative will analyze, research, and recommend/take appropriate steps to resolve the credit balance account. Accounts resulting in an overpayment will be monitored by the Credit Resolution Representative through to resolution.

Additionally, the Resolution Representative is responsible for the communication with their day-to-day contacts, answering all questions and inquiries that may generate from recommendations made or individual accounts that need addressed quickly.  The Resolution Representative will also participate in the weekly/monthly/quarterly presentations with their supervisor or management, regarding credit balance reduction, and recommended actions to keep credit balances within overall required volumes, dollars and age. The Resolution Representative will work closely with their credit balance teammates, areas within the Patient Financial Department, and Leaders to continually improve upon credit resolution timeliness, credit root-cause solutions and operational best practices.

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. It may be necessary, given the business need, to work occasional overtime. Employees are required to work 2 days onsite and 3 days from home.

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

If you are within commutable distance to the office at 43 Whiting Hill Road, Brewer, ME  04412, you will have the flexibility to work from home and the office in this hybrid role* as you take on some tough challenges.

                          

Primary Responsibilities:

• Provide expertise by reviewing, researching, and resolving all types of accounts in a credit balance to bring final resolution and root cause analysis for health plans, commercial clients and government entities

Fundamental Execution

• Plan, prioritize, organize and complete work to meet established production goals required by provider clients, as well as Optum goals, quotas and deadlines in a fast pace and ever-changing environment
• Provide top quality by researching accounts fully, reviewing and adhering to payer, provider & Optum quality requirements
• Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance

Inventory Management

• Credit Balance follow up and resolution, ensuring required compliance account timeliness guidelines are met within 30/60/180 days. Follow up includes researching why inventory is outstanding and working with Optum management and provider client to ensure resolution
• Manage multiple different inventory work queues and workflows, including multiple payer and provider client referred credit inventory, as well as unsolicited/correspondence inventory

Reporting & Analysis

• Analyze and identify trends and provide reporting as necessary to provider clients, management
• Utilize various workflow applications and reports to manage inventory, follow up as needed & drive client relationships
• Work independently with little direct onsite supervision
• Build relationships with day-to-day contacts at assigned provider; Accounting, customer service, Accounts Receivable, contracting, business support teams, etc
• Collaborate with peers assigned to provider client to make sure best in class principles are applied to all credit balance reduction approaches

                                     

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
• 1+ years of experience in revenue cycle and/or accounts payable reconciliation
• Experience with Microsoft Word (create correspondence and work within templates), Microsoft Excel (data entry, sort / filter, and work within tables) and Microsoft Outlook (email and calendar management)
• Ability to work a hybrid schedule, with onsite presence up to two days per week at 43 Whiting Hill Road, Brewer, ME 04412
• Ability to work 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. It may be necessary, given the business need, to work occasional overtime

                           

Preferred Qualifications:

• 2+ years of experience in claims recovery and resolution for an operations-based environment
• 2+ years of customer service experience
• Experience with payment variance resolutions
• Healthcare finance experience with a focus in auditing and/or analysis

                            

Telecommuting Requirements:

• Reside within commutable distance to the office at 43 Whiting Hill Road, Brewer, ME  04412
• 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:

• Proven solid Communication and Customer Service skills
• Proven exceptional organizational/time management skills
• Demonstrated ability to work in a dynamic environment both independently and in a group setting

                           

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

                         

The hourly range for this role is $16.88 to $33.22 per hour based on full-time employment. 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.

                           

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.

                                                     

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