Position Description:Healthcare isn't just changing.It's growing more complex every day. ICD-10 Coding replaces ICD-9. AffordableCare adds new challenges and financial constraints. Where does it all lead?Hospitals and Healthcare organizations continue to adapt, and we are vital partof their evolution. And that's what fueled these exciting newopportunities. Who are we? Optum360.We're a dynamic new partnership formed by Quest and Optum to combineour unique expertise. As part of the growing family of UnitedHealth Group, we'll leverage our compassion, our talent, ourresources and experience to bring financial clarity and a full suite of RevenueManagement services to Healthcare Providers, nationwide. If you're looking for a better place to use yourpassion, 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.Primary Responsibilities: Comply with departmental Business Rules and SOPs Focused efforts on decreasing the AR>90, increasing cash, reducing bad debt Analyze and apply denials to third party carriers in all media types Interpret Explanation of Benefits for appropriate follow up action Complete refunds / adjustments to customer's accounts, while providing necessary back-up information in order to maintain accuracy Complete timely carrier recoupment requests Utilize automation tools to verify eligibility and claim status or to obtain better billing information Contact Third Party carriers to follow up on denied and unresponded claims Create worklist through Access Database and manipulate data to analyze for trends and resolve claims for adjudication Evaluate and respond to all aspects of written billing inquiries from the patients, clients or 3rd party carriers in order to resolve billing issues Resolve claims through contact with insurance carriers, clients, patients and/or other outside sources Regular research involving both the web and billing systems Maintain Compliance and HIPAA standards at all times May be a certified Medical Coder or involved with medical coding. Meet or exceed daily production standards Meet or exceed daily quality standards Ability to work on various other projects as needed
Required Qualifications: High School Diploma / GED (or higher) 1+ years stable work experience; 1-3 years' experience in A/R, Billing, Customer Service, insurance or healthcare Experience creating and modifying Microsoft Excel spreadsheets Previous experience clearly conveying procedural information, issues and requirements (within the last year) Available to work 40 hours per week anytime within the operating hours of the site (between 6:30 am - 5:00 pm CST) and ability to work overtime as needed based on department needsSoft Skills: Ability to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each product Ability to remain focused and productive each day though tasks may be repetitivePhysical Requirements and Work Environment: Service center environment with moderate noise level due to Representatives talking, computers, printers, and floor activity Frequent speaking, listening using a headset, sitting, use of hands/fingers across keyboard or mouse, handling other objects, long periods working at a computerCareerswith OptumInsight. Information and technologyhave amazing power to transform the Healthcare industry and improve people'slives. This is where it's happening. This is where you'll help solve theproblems that have never been solved. We're freeing information so it can beused safely and securely wherever it's needed. We're creating the very bestideas that can most easily be put into action to help our clients improve thequality of care and lower costs for millions. This is where the best and thebrightest work together to make positive change a reality. This is the place todo your life's best work.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, training class, Optum, adjustments, phone support, back-end
Internal Number: 747896
About UnitedHealth Group
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.