Billing Representative – Remote in EST or CST Time zone

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.

As a Billing Representative – Third Party you’ll play a critical role in creating a quality experience that impacts the financial well-being of our patients. You’ll be the expert problem solver as you work to quickly identify, analyze and resolve issues in a fast paced environment.  This is your chance to take your career to the next level as you support teams by reviewing, and investigating claims.  Bring your listening skills, emotional strength and attention to detail as you work to ensure every claim has a fair and thorough review.

You will leverage your skills and have the ability to:

• Multi-task and work independently and as part of a team.
• Demonstrate excellent communication, organization and problem solving
• Adapt to change in a fast-paced environment
• Join a cross functional focused team with many opportunities for cross-training and skill/career development

If selected for this position, it is required that you successfully complete the UnitedHealth Group new hire training and demonstrate proficiency to continue in the role.  

This position is full time 40 hours/week Monday – Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8am – 5pm EST. It may be necessary, given the business need, to work occasional overtime and/or weekends or holidays.

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

If you are located in Eastern or Central Time zone, you will have the flexibility to work remotely* as you take on some tough challenges.

 

Primary Responsibilities:

• Analyzes and applies denials to third party carriers in all media types
• Complies with departmental Business Rules and Standard Operating Procedures
• Focuses efforts on decreasing the Accounts Receivable, increasing cash, and/or reducing bad debt
• Interprets explanation of benefits for appropriate follow up action
• Utilizes automation tools to verify eligibility, claim status and/or to obtain better billing information
• Creates worklist through Access database and manipulate data to analyze for trends and resolve claims for adjudication
• Reviews and research denied claims by navigating multiple computer systems and platforms, in order to accurately capture data/information for processing
• Communicates and collaborates with members or providers to evaluate claims errors/issues, using clear, simple language to ensure understanding
• Conducts data entry and re-work for adjudication of claims
• Works on various other projects as needed
• Meets the performance goals established for the position in the areas of efficiency, accuracy, quality, patient and client satisfaction and attendance

 

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.

• High School Diploma/GED OR equivalent work experience
• Must be 18 years OR older
• Proficiency with Windows personal computer applications, which includes the ability to navigate multiple programs and learn new and complex computer system applications
• Strong keyboard and navigation skills and ability to learn new computer programs 
• Experience working with Microsoft Excel (filtering, sorting, working within tables)
• Reside within in EST or CST time zone 
• Ability to work Monday – Friday, 08:00AM – 05:00PM EST

• 1+ years of experience in a related environment (i.e., office, administrative, clerical, customer service, etc.), using phones and computers as the primary job tools
• 1+ years’ experience in A/R, Billing, and Customer Service, Insurance, or Healthcare
• Medical terminology acumen and experience

• Reside within Eastern or Central Time zone
• 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

• Ability to multi – task and to understand multiple products and multiple levels of benefits within each product
• Ability to resolve calls, avoiding escalated complaints
• Ability to exhibit empathy and be courteous to callers
• Ability to triage and handle escalated situations
• Ability to work in a fast-paced environment
• Ability to adapt to changes
• Ability to develop and maintain client relationships