Are you looking to be on the forefront of reducing the cost of healthcare through cost containment and compliance? Do you consider yourself a critical thinker, problem solver, and process improver? Do you have the ability to analyze numbers and identify trends while being able to build lasting relationships? Do you want to work for one of the leading revolutionary healthcare companies that affect every aspect of the healthcare system?
Payment Resolution Services (PRS) is a call center with the focal point of handling information about services patients receive and the way those services get paid. It's complex, detailed work. It's also fast paced and challenging. It's a job that calls on you to be thoughtful, resourceful, team-driven and customer-focused. To put it mildly, there is never a dull moment.
The PRS Team Lead works as a support liaison for front line analysts regarding information about patient services and how those services are paid by investigating and pursuing recoveries through contact with various parties. The team lead works directly with the analyst to recover over payments through multiple communication methods including phone, email, fax and postal mail. We offer the latest tools along with the most intensive training program in the industry and nearly limitless opportunities for advancement.
- Provide claims expertise support by reviewing, researching, investigating, negotiating, and resolving all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities
- Fundamental Execution: Plan, prioritize, organize and complete work to meet established production goals, quotas and deadlines in a fast pace and ever changing environment
- Communicate professionally with healthcare providers and internal partners to ensure PRS is meeting the needs and expectations of the client; build a good rapport with the provider contacts by establishing professional working relationships to ensure timely recoveries
- Analyze, identify trends, and provide inventory and or client updates as necessary
- Must meet state and federal compliance policies, reimbursement policies, and contract compliance
- Works independently and as part of a team with high energy and a positive attitude
- Mentors and Coaches others with the ability to encourage, challenge, and provide feedback in a constructive professional manner.
- Acts as a resource for others in the department
- Perform other duties as assigned
- High School Diploma / GED or higher
- 1+ years of claims experience
- 1+ years of outbound call center experience with analyzing and solving customer problems
- Experience working in the healthcare industry
- Ability to create, edit, copy, send and save documents, correspondence, and spreadsheets in MS Word, Excel, and Outlook
- Must be able to work a standard 40 hour work week Monday - Friday. It may be necessary, given the business need, to work occasional overtime or weekends.
- Bachelor’s Degree or higher
- Provider over-payment recovery experience
- Professional billing or claims experience
- Experience with negotiations
- Previous work within the community giving back or volunteering time and resources
- Ability to work in a dynamic environment both independently and in a group setting
- Strong Communication and Customer Service skills
- Extended periods of sitting at a computer and use of hands/fingers across keyboard or mouse, speaking, listening using a headset.
- Business office environment with moderate noise level due to Representatives talking, computers, printers, and floor activity
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do 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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