Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

This position is full-time Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:45am - 5:15pm CST. It may be necessary, given the business need, to work occasional overtime including holidays. Employees are required to work some days onsite and some days from home.

We offer weeks of paid training. The hours during training will be 8:45am to 5:15pm, Monday - Friday.

If you are within commutable distance to the office at 6860 West 115 Overland KS 66211, you will have the flexibility to work from home and the office in this hybrid role* as you take on some tough challenges.

Primary Responsibilities:

Review open AR and prioritize pharmacy claim activities

Develop relationships with payers to obtain claim requirements and resolve root causes

Assure that timely and accurate follow up activity is performed on all pharmacy claims that are not paid within 45 days of submission

Responsible for review and documenting of key accounts

Identify issues/trends and escalate to Supervisor/Manager when assistance is needed.

Develop relationships with other departments to provide feedback about root cause issues

Provides exceptional customer service to internal and external customers

Answer incoming calls on an inbound phone que from patients or their representative, regarding patient bill balances, payment plans, credit card payment, patient pricing, re-billing insurance companies, copay assistance programs and general customer concerns.

Process payments, adjustments, refunds, and transfer payments

Evaluate and respond to email requests regarding patient billing inquires

Research, troubleshoot and resolve complex billing issues and customer complaints, taking all steps to resolve and ensure full resolution

Use, email and phones to contact customers to discuss, negotiate payment and resolve outstanding pharmacy accounts and balances

Obtain agreement and potential balance payoff and/or payment terms within stated level of authority and guideline limits

Other duties as assigned

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

High School Diploma / GED

Must be 18 years of age or older

1+ years of experience with pharmacy claim adjudication or pharmacy claim collections accounts receivable OR 1+ years BriovaRx/Optum Specialty Pharmacy / Drugs experience

1+ years experience performing multiple concurrent tasks with strong attention to detail

1+ years basic level skills in Microsoft Excel (opening a workbook, inserting a row, selecting font style and size)

1+ years basic level skills in Microsoft Outlook (creating and replying to emails)

1+ years of experience working in a inbound customer service call center in the healthcare industry

Ability to attend on site at least 2 times per week or per business need

Ability to work any 8 - hour shift during normal business hours between 8:45am – 5:15pm CST, Monday - Friday

Preferred Qualifications:

Specialty Pharmacy experience

Prior customer service experience analyzing and solving customer’s concerns.

Prior Pharmacy billing experience

Prior experience working with or billing copay assistance programs.

Experience in a related environment (i.e., office, call center, customer service, etc.) using phones and computers as the primary job tools

Telecommuting Requirements:

Reside within commutable distance to the office at 30 miles from 6860 West 115 Overland KS 66211

Ability to keep all company sensitive documents secure (if applicable)

Required to have a dedicated work area established that is separated from other living areas and provides information privacy.

Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

Soft Skills:

Proven proficiency with de-escalation

Proven ability to communicate effectively

Demonstrated customer service skills

Demonstrated conflict management skills including the ability to resolve stressful situations

Demonstrated ability to listen skillfully, collect relevant information, build rapport, and respond to customers in a compassionate manner

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

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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