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　　Position in this function is responsible for performing complex or specialized collection functions by interfacing with various departments, insurance carriers, patients and providers while ensuring good patient and provider relations. Serves as patient advocate to help resolve problems pertaining to patient statements as well as any other issues that may arise.

　　Primary Responsibilities:

　　Consistently exhibits behavior and communication skills that demonstrate Optum’s commitment to superior customer service, including quality, care and concern with each and every internal and external customer

　　Provides timely resolution to incoming calls to the Business Office

　　Returns telephone messages left on the ACD voicemail box according to department standards

　　Documents all calls as clearly and precisely at the time of call

　　Researches on inquiries from callers (patients, site staff, insurance companies, etc.) in a timely manner. Performs necessary follow-up to ensure timely resolution of patient concerns and inquiries including appeals, re-billing, obtaining updated insurance information, identifying and correcting billing errors, etc.

　　Maintains department productivity standards

　　Maintains up-to-date information on Medicare laws, HCFA requirements, PPO contractual arrangements and other third-party payors

　　Performs collection activities on assigned work files according to department procedures

　　Uses, protects, and discloses Optum patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards

　　Performs additional 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:

　　3+ years of insurance follow up experience

　　Knowledge of CPT and ICD-10 coding

　　Knowledge of Medicare laws, HCFA requirements, PPO, HMO, Medi-Cal, Worker’s Compensation and third-party billing and collection guidelines

　　Ability to work in a Hybrid role (1x per week in our El Segundo, CA office)

　　Preferred Qualifications:

　　Knowledge of HCFA and California Industrial fee schedule billing requirements

　　Working knowledge of current state and federal laws governing collections

　　Bilingual-Spanish

　　Proven ability to handle difficult situations in a positive manner

　　Proven good verbal and written communication skills. Must have good command of the English language in order to document all calls using complete sentences and correct spelling

　　Proven to be organized, flexible and detail-oriented

　　California Residents Only: The hourly range for California residents is $16.00 to $32.55 per hour. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

　　OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.