You’ll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.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.Under the general direction of the Revenue Cycle Management Supervisor, this position is responsible for the medical billing and collection. The Billing Representative is responsible for ensuring accurate billing, timely submission of electronic and / or paper claims, monitoring claim status, researching rejections and denials, documenting related account activities, posting adjustments and collections of Medicare, Medicaid, Medicaid Managed Care, and commercial insurance payers. The Billing Representative must possess critical thinking skills and understanding of Medicare, Medicaid eligibility requirements as well as commercial insurance payer payment methods to correctly record contractual adjustments base on payer contracts or government regulations. In addition, the medical billing and collection specialist must demonstrate proficiency with billing system to ensure all functionality is utilized for the utmost efficient processing of claimsThis position is full-time, Monday - Friday. Employees are required to work our normal business hours of 7:00 AM - 3:30 PM PST.All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.Primary Responsibilities:
Responsible for charge and payment entry within Electronic Health Record
Coordinates and clarifies with providers, when necessary, on information that seems incomplete or is lacking for proper account / claim adjudication
Responsible for correcting, completing, and processing claims for all payer codes
Analyze and interpret that claim are accurately sent to insurance companies
Perform follow up with Medicare, Medicaid, Medicaid Managed Care, and Commercial insurance companies on unpaid insurance accounts identified through aging reports
Process appeals online or via paper submission
Assist in reconciling deposit and patient collections
Assist with billing audit related information
Process refund requests
Communicate with billing and credentialing coordinator to identify and resolve audit review issues
Process billing calls and questions from patients and third - party carriers
Answer / respond to correspondence related to patient accounts. Is available to answer billing and changes related inquiries by patients, staffs, Managed Care Organization
Communicate daily with internal and external customers via phone calls and written communications
Identify trends, and carrier issues relating to billing and reimbursements
Report findings to Team Lead and / or Supervisor
Research, record findings, and communicates effectively with Manager to achieve optimum performance
Pursue and participate in education to remain current with changes in the Healthcare industry
Maintain patient confidence and protects medical office operations by keeping patient information confidential
Contribute to team effort by accomplishing related results as needed
Promote effective working relations and work effectively as part of a team to facilitate the department’s ability to meet its goals and objectives
Demonstrate respect and regard for the dignity of all patients, families, visitors, and fellow employees to insure a professional, responsible and courteous environment
Perform other duties as assigned to support Excel’s Mission, Vision, and Values
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
2+ years of experience with working in the medical field such as billing, coding, OR medical insurance
2+ years of experience in working with Medicare / Medicaid / Managed Care claims
Familiarity with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications (Microsoft Word, Microsoft, Excel, and Microsoft Outlook)
Ability to work any shift between the hours of 7:00 AM - 3:30 PM PST from Monday - Friday
Must be 18 years of age OR older
Preferred Qualifications:
Bilingual fluency in English and any of the following: Spanish, Vietnamese, Chinese, Tagalog
Previous experience in a medical office setting and / OR experience with an Electronic Medical Records
Knowledge of healthcare regulations and guidelines including CMS, DMHC, and / OR DHCS guidelines
Knowledge of Correct Coding Initiative, HCFA - 1500 and UB - 92 claim forms, and CPT Coding
Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume
Ability to apply concepts of basic algebra
Understanding of medical terminology and insurance laws / guidelines
Telecommuting Requirements:
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:
Ability to apply common sense understanding to carry out instructions furnished in written, oral, and diagram form
Ability to deal with problems involving several concrete variables in standardized situations
Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources
Detail - oriented
Ability to solve problems through systematic analysis of processes with sound judgment
Has a realistic understanding of relevant issues
Demonstrate accountability for one’s own actions
Complete routine and priority tasks within departmental time frames
Convey care when answering phone calls and assisting customers
Demonstrate the ability to effectively interact with both external and internal customers in difficult situations
Demonstrate ability to make sound decisions
Maintain confidentially when handling sensitive material
Ability to speak effectively before groups of customers or employees of the organization
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Washington, or Rhode Island Residents Only: The hourly range for California / Colorado / Connecticut / Hawaii / Nevada / New York / New Jersey / Washington / Rhode Island residents is $16.54 - $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: 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.#RPO #GREEN
