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
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