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 (40 hours / week), Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 AM - 5:00 PM CST.

We offer 4 weeks of paid on-the-job training. The hours of training will be aligned with your schedule during normal business hours.

If you are located within the Central OR Eastern Time Zone, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

Perform research on assigned payer guidelines when processing appeals, corrected claims or denial reasons.

Stay up to date on all payer requirements and changes

Comply with departmental Business Rules and Standard Operating Procedures

Focus efforts on decreasing the Accounts Receivable, increasing cash, and / or reducing bad debt

Interpret explanation of benefits for appropriate follow up action

Utilize automation tools to verify eligibility, claim status and / or to obtain better billing information

Create work list through database and manipulate data to analyze for trends and resolve claims for adjudication

Review and research denied claims by navigating multiple computer systems and platforms, in order to accurately capture data / information for processing

Communicate and collaborate with members or providers to evaluate claims errors / issues, using clear, simple language to ensure understanding

Work on various other projects as assigned / needed

Meet the performance goals established for the position in the areas of: efficiency, accuracy, quality, patient and client satisfaction and attendance

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

2+ years of medical collections and / OR medical billing experience

1+ years of experience in working with insurance companies on denied healthcare claims

Computer phone skills, including working knowledge of Microsoft Windows and navigation, mouse and keyboarding skills

Intermediate level of experience with Microsoft Word (creating and editing documents)

Intermediate level of experience with Microsoft Excel (data entry, sorting / filtering)

Ability to work any of our shift schedules during our normal business hours of 8:00 AM - 5:00 PM CST from Monday - Friday

Preferred Qualifications:

Knowledge of full version Adobe (creating and editing documents)

Medical claims experience

Medicare OR Medicaid collections experience

EOB experience

Telecommuting Requirements:

Reside within the Central OR Eastern Time Zone

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

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

Connecticut, New Jersey, New York, Rhode Island, Washington, D.C., Maryland Residents Only: The hourly range for this role is $16.54 to $32.55 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

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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