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We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM


Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com


Job Category:

Business Operations



Approximate Salary:

Not Specified

Position Type:

Full Time

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Medicare Manager of Operations - Phoenix, AZ

UHG - Phoenix, Arizona

Posted: 12/7/2018

If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work.(sm)


Primary Responsibilities:
  • Manage the work of the billing and collections team members by empowering, coaching, answering questions, giving guidance, and leading by example 
  • Manage  COE operations, ensuring timeliness, accuracy, compliance and standards fulfillment as defined in COE Service Level Agreements 
  • Ensure that adequate procedures exist for accurate and timely processing for billing and collections
  • Ensure compliance with state and federal laws for all payors
  • Maintain ongoing knowledge of UB-92, HFCA 1500, and other mandatory state billing forms and filing requirements 
  • Monitor on-line claim editing, submission and reconciliation procedures; ensure compliance with CPT, HCPCS and ICD-9 coding regulations and guidelines 
  • Help coordinate follow-up within appropriate regulations 
  • Provide relevant guidance for assigned Supervisors and staff to resolve internal and external issues 
  • Inform Director of any significant issues in the Billing and Collections area (e.g., Billing and Collection backlogs, HIM bill drop delays, payer issues, vendor issues, etc.) 
  • Stay abreast of regulatory requirements and company compliance policies, ensuring timely staff education 
  • Help ensure that appropriate personnel policies are adhered to and any personnel problems are addressed in an appropriate and timely manner 
  • Assist in hiring, managing and developing department staff to ensure appropriate skills base is present in the staff, as well as to ensure that skills needed for future needs are developed in advance of their need 
  • Assist in establishing and monitoring controls to ensure appropriate submission and acceptance of electronic and manual bills 
  • Monitor billed and rebilled summary reports and act on trends and/or root causes 
  • Monitor Billing and collection performance according to quality and productivity standards developed internally and documented in SLAs 
  • Support completion of monthly trending analysis of  COE billing and collection performance 
  • Help coordinate and promote implementation and monitoring of standard master files, processes, reporting and education programs 
  • Understand and communicate nuances of billing various payers such as Medicare, Medicaid, HMO’s, PPO’s, IPA’s, employers, etc. 
  • Manage Billing and Collection personnel, provide recommendations for hiring, promotion, and personnel action where appropriate 
  • Assist Solutions Management and COE Implementation staff in company-wide initiatives such as the development of operational models, education programs and national contract compliance 
  • Develop specific objectives and performance standards for each area of responsibility 
  • Identify and implement process improvements to lower costs and improve service to facility customers 
  • Identify opportunities for innovation, knowledge sharing and other leading practices within the COEs and among peer group 
  • Perform staff reviews and prepare performance documents for direct reports 
  • Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement” 
  • Other duties as assigned

Required Qualifications:
  • 5+ years of Billing and Collection experience 
  • 5+ years of Healthcare Management, Hospital and / or Revenue Cycle Management experience 
  • Willingness to travel up to 25%
Preferred Qualifications:
  • Bachelor's degree 

Careers with Optum360. At Optum360, we're on the forefront of health care innovation. With health care costs and compliance pressures increasing every day, our employees are committed to making the financial side more efficient, transferable and sustainable for everyone. We're part of the Optum and UnitedHealth Group family of companies, making us part of a global effort to improve lives through better health care. In other words, it's a great time to be part of the Optum360 team. Take a closer look now and discover why a career here could be the start to doing your life's best work.(sm)


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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