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?
Our Credit Balance Claims Operations are 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.
This role handles information about patient services and how those services are paid by investigating and pursuing recoveries through contact with various parties. There are 2 primary functions. First, reviewing and analyzing contract rates on credit balance accounts at the hospital business office. You will be required to use basic math in all of your daily activities. As field - based employees who work onsite at our client’s offices; relationship building and growth is another crucial function of the position. Acclimating to our client’s environment and learning about their primary goals and objectives is essential, and ensures a successful partnership. Responsibilities include regular communication with client contacts at all levels to follow - up on open AR, discuss reporting, projects and identifying opportunities for growth of the business partnership. We offer the latest tools along with the most intensive training program in the industry and nearly limitless opportunities for advancement. This position also offers quarterly incentives based on performance.
- Provide expertise by reviewing, researching, and resolving all types of accounts in a credit balance to bring final resolution and root cause analysis 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 and / or meet with the provider appropriately to ensure Optum is meeting the needs and expectations of the provider and build a good rapport with the provider contacts by establishing professional working relationships to ensure operational efficiency
- Anticipates customer needs and proactively identifies solutions, be accountable for improving business operations
- Accounts receivable follow up and resolution
- Analyze and identify trends and provide reporting as necessary
- Work independently with little direct onsite supervision
- Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance
- High School Diploma / GED or higher
- Basic proficiency in math and thinking analytically and strategically
- Intermediate proficiency with PC and Windows
- Intermediate level of proficiency with Microsoft Excel (i.e. sorting, summing, creating bar graphs, formulas)
- Working Hours - business hours - 40 hours standard, OT if business needs dictate but not regular
- Ability to travel, up to 25% of the time (generally local, but some overnight) required
- Bachelor’s Degree or higher
- Previous experience working in a client facing role and / or working onsite at a client site
- 3+ years of experience in claims recovery and resolution or an operations based environment
- Healthcare finance experience with a focus in auditing and / or analysis
- 2+ years of Account Management or Customer Service experience
- Previous leadership experience
- 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
Physical Requirements and Work Environment:
- 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.
Keywords: Optum, healthcare, Recovery, Claims, Billing, Resolutions, Customer Service, Client Facing