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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
Primary Responsibilities:
•Review outstanding insurance balances to identify and resolve issues preventing finalization of claim payment; including coordinating with payers, patients and clients when appropriate
•Analyze and trend data, recommending solutions to improve first pass denial rates and reduce age of overall AR
•Ensure all workflow items are completed within the set turn-around-time within quality expectations
•Be able to analyze EOBs and denials at a claim level in addition they should find trends impacting dollar and #'s, leading to process improvements
•Perform other duties as assigned
•Comply with all applicable Company policies, procedures, and business directives, changes including those relating to work location, team assignments, work schedules, and flexible work arrangements
Required Qualifications:
•Graduate
•12+ months and above experience in healthcare accounts receivable (Denial Management)
•Accounts Receivable Specialist that has an 'understanding' of the whole accounting cycle / claim life cycle
•Functional knowledge of HIPAA rules and regulations and experience related to privacy laws, access and release of information
•In-depth working knowledge of the various applications associated with the workflows
•Solid knowledge of medical insurance (HMO, PPO, Medicare, Medicaid, Private Payers)
•Solid knowledge and use of the American English language skills with neutral accent
•Proficient in MS Office software; particularly Excel and Outlook
•Proven ability to communicate effectively with all internal and external clients
•Proven ability to use good judgment and critical thinking skills; ability to identify and resolve problems
•Proven efficient and accurate keyboard/typing skills
•Demonstrated solid work ethic and a high level of professionalism with a commitment to client/patient satisfaction
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.
