Collections Representative - National Remote

Company: UnitedHealth Group
Location: Sun City Center
Posted on: May 24, 2023

Job Description:

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 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 is a challenging role that requires providing best in class service to our customers during their times of difficulty. It's a fast-paced environment that requires focus and ability to multi-task throughout the day. This is a 40-hour, full time role working flexible shifts, sometimes including evenings or Saturdays. We require our employees to be flexible enough to work any shift, any day of the week during those hours.This position is full-time (40 hours/week) Monday - Friday, sometimes including evenings or Saturdays. 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.*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.Primary Responsibilities:

• Perform research on various computer systems and document customer information regarding current status, payment expectations, notes of conversations and other relevant information
• Use mail, email and phones to contact customers to discuss, negotiate payment and resolve outstanding medical bill accounts and balances
• Obtain agreement on potential balance payoff and/or payment terms within stated level of authority-- and guideline limits
• Prepare and submits reports to internal management on status of outstanding medical bills and proposed/planned payment settlement detailsYou'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 (or higher)
  • 2+ years of hospital patient accounting experience with a focus on insurance follow-up
  • 2+ years of working denials from beginning to end to include writing and handling appeals
  • Facility experience
  • Knowledge of ICD10, CPT, HCPC codes
  • Knowledge of managed care protocols for coverage, based on-- illness/injury and whether provider is in or out of network
  • Understanding of claim denials and actions required for insurance payment/resolution (know when to escalate)
  • Proficiency knowledge of Microsoft Excel, Outlook, and Word
  • Proficiency knowledge of value codes, condition codes and modifiers
  • UB-04 Medicare Part A & B
  • General computer knowledge with good typing skills
  • Ability to work in and maneuver through DDE
  • Ability to correctly bill various insurances
  • Ability to accurately read and interpret EOBs
  • Ability to work 8:00am - 4:30pm EST Monday - Friday, sometimes including evenings or Saturdays--Preferred Qualifications:
    • California Medi-CAL experience
    • Hospital revenue cycle experience
    • Ability to review and correct Medicaid claims (on-line)
    • Proficiency in Medicaid regulations & guidelines
    • In-depth understanding of crossover claims (Medicaid)
    • Working knowledge of Medicare Regulatory Guidelines
    • Medicare claim resolution (from open to close - not solely status)
    • Working knowledge of Florida Shared System (FSS) (Medicare)Telecommuting Requirements:
      • Required to have a dedicated work area established that is separated from other living areas and provides information privacyAbility to keep all company sensitive documents secure (if applicable)Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet serviceSoft Skills:
        • Strong analytical and research skills
        • Dependable, flexible, and able to work in a team environment
        • Ability to work in a production environment and be goal oriented
        • Excellent organizational skills and be able to prioritize workflow
        • Ability to regularly demonstrate excellent follow-up
        • Strong analytical and research skills
        • Must be able to speak clearly and audibly while working directly with payers, clients and patients
        • Personally resolved their own denials (med necessity, eligibility, compliance, etc)Careers with OptumInsight. Information and technology have amazing power to transform the Healthcare industry and improve people's lives. This is where it's happening. This is where you'll help solve the problems that have never been solved. We're freeing information so it can be used safely and securely wherever it's needed. We're creating the very best ideas that can most easily be put into action to help our clients improve the quality of care and lower costs for millions. This is where the best and the brightest work together to make positive change a reality. This is the place to do your life's best work.SMCalifornia, Colorado, Connecticut, Nevada, Washington or New York, Rhode Island Residents Only: The salary range for California / Colorado / Connecticut / Nevada / Washington / New York / Rhode Island residents is $16.00 - $31.44.Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.#RPO #YELLOW

Keywords: UnitedHealth Group, Palmetto , Collections Representative - National Remote, Accounting, Auditing , Sun City Center, Florida