Healthcare isn’t just changing. It’s growing more complex every day. ICD - 10 Coding replaces ICD - 9. Affordable Care adds new challenges and financial constraints. Where does it all lead? Hospitals and Healthcare organizations continue to adapt, and we are vital part of their evolution. And that’s what fueled these exciting new opportunities.
Who are we? Optum360. We’re a dynamic new partnership formed by Quest and Optum to combine our unique expertise. As part of the growing family of UnitedHealth Group, we’ll leverage our compassion, our talent, our resources and experience to bring financial clarity and a full suite of Revenue Management services to Healthcare Providers, nationwide.
If you’re looking for a better place to use your passion, your ideas and your desire to drive change, this is the place to be. It’s an opportunity to do your life’s best work.
- Focus efforts on increasing cash and reducing bad debt
- Process and review claims and appeals
- Evaluate and respond to all aspects of written billing inquiries from the patient or their representative in order to resolve billing issues
- Make contact with insurance carriers, clients, patients and / or other outside sources
- Regular research involving both the web and billing systems
- Submit claims daily to Emdeon and work all errors and rejections
- Process pre - authorizations and pre - determinations for all contracted insurances when appropriate
- Maintain Compliance and HIPAA standards at all times
- Meet or exceed daily production standards
- Meet or exceed daily quality standards
- Ability to work on various other projects as needed
- High School Diploma / GED (or higher)
- 6+ months of experience in A / R which includes experience interpreting Explanation of Benefits for appropriate follow up action, completing refunds / adjustments to customer’s accounts, while providing necessary back - up information in order to maintain accuracy, contacting Third Party carriers to follow up on denied and un - responded claims, analyzing and applying denials, and experience processing and reviewing claims and appeals
- Ability to create and modify spreadsheets within Microsoft Excel
- Ability to use a keyboard for data entry skills
- Ability to work overtime as needed and work Monday - Friday, 8 - hours a day between the hours of 7:00 am - 6:30 pm EST
- Associate’s Degree (or higher)
- Ability to work within multiple applications with dual computer screens
- Excellent communication skills
- Demonstrated problem solving skills
- Good organizational skills
- Ability to work independently and as part of a team
- Frequent speaking, listening using a headset, sitting, use of hands / fingers across keyboard or mouse, handling other objects, long periods working at a computer
- Service center environment with moderate noise level due to Representatives talking, computers, printers, and floor activity
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.
Keywords: billing, claims, medical claims, healthcare claims, office, UnitedHealth Group, Optum, OptumRx, training class, customer service representative, customer service, CSR, Data Entry, adjustments, phone support