Billing Representative - Remote In Multiple Locations

If you are located within Florida, Anderson, South Carolina, OR Pennsylvania , you will have the flexibility to telecommute* (work from home) 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.

Are you looking for a chance to get your foot in the door with a great company? You’ve found it here. Already one of the world’s leading health care companies, Optum, part of the UnitedHealth Group family of businesses, is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. Here, you’re not just working. You’re making great things happen for the people who rely on us for health care across the United States. You’re part of an elite team that’s equipped with the best tools and resources, the most thorough training and learning opportunities and a mission that can inspire you every day.

Healthcare isn’t just changing. It’s growing more complex every day. ICD - 10 Coding replaces ICD - 9. Affordable Care adds new challenges and financial constraints. Where does it all lead? Hospitals and Healthcare organizations continue to adapt, and we are vital part of their evolution. And that’s what fueled these exciting new opportunities.

Who are we? Optum360. We’re a dynamic new partnership formed by Quest and Optum to combine our unique expertise. As part of the growing family of UnitedHealthGroup, we’ll leverage our compassion, our talent, our resources and experience to bring financial clarity and a full suite of Revenue Management services to Healthcare Providers, nationwide.

If you’re looking for a better place to use your passion, your ideas and your desire to drive change, this is the place to be. It’s an opportunity to do your life's best work.SM

As a Billing Representative - Third Party you’ll play a critical role in creating a quality experience that impacts the financial well-being of our patients. You’ll be the expert problem solver as you work to quickly identify, analyze and resolve issues in a fast paced environment. This is your chance to take your career to the next level as you support teams by reviewing, and investigating claims. Bring your listening skills, emotional strength and attention to detail as you work to ensure every claim has a fair and thorough review.

This position is full-time (40 hours / week), Monday - Friday. Employees are required to work our normal business hours of 7:00 AM - 3:30 PM EST. It may be necessary, given the business need, to work occasional overtime, weekends, and / or holidays.

We offer weeks of paid training. The hours of the training will be based on selected shift or will be discussed on your first day of employment. Training will be conducted virtually from your home.

• All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary Responsibilities:

• Analyzes and applies denials to third party carriers in all media types.
• Complies with departmental Business Rules and Standard Operating Procedures.
• Focuses efforts on decreasing the Accounts Receivable, increasing cash, and / or reducing bad debt.
• Interprets explanation of benefits for appropriate follow up action.
• Utilizes automation tools to verify eligibility, claim status and / or to obtain better billing information.
• Creates worklist through Access database and manipulate data to analyze for trends and resolve claims for adjudication.
• Reviews and researches denied claims by navigating multiple computer systems and platforms, in order to accurately capture data / information for processing.
• Communicates and collaborates with members or providers to evaluate claims errors / issues, using clear, simple language to ensure understanding.
• Conducts data entry and re - work for adjudication of claims.
• Works on various other projects as needed.
• Meets the performance goals established for the position in the areas of: efficiency, accuracy, quality, patient and client satisfaction and attendance.
• This position is full-time (40 hours/week) Monday – Friday. It may be necessary, given the business need, to work occasional overtime and/or weekends or holidays.

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
• Demonstrated ability using computer and Windows PC applications, which includes strong keyboard and navigation skills and ability to learn new computer programs.
• 1+ years of experience in Billing, Customer Service, OR Healthcare.
• Ability to work full-time (40 hours / week), Monday - Friday. Employees are required to work our normal business hours of 7:00 AM - 3:30 PM EST. It may be necessary, given the business need, to work occasional overtime, weekends, and / or holidays.
• Must be 18 years of age OR older

Preferred Qualifications:

• Medical terminology acumen
  
• Certified medical coder or involved with medical coding.
• Previous experience with medical claims processing

Telecommuting Requirements:

• Reside within Florida, Anderson South Carolina OR Pennsylvania OR near these locations: Florida location- 4151 C East Fowler Ave. Tampa, FL 33617 OR PA location-15 Campus Blvd Newtown Square, PA 19073 OR SC Location- 1502 E Greenville Street, Anderson, South Carolina 29621
• 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 resolve calls, avoiding escalated complaints.
• Ability to exhibit empathy and be courteous to callers.
• Ability to triage and handle escalated situations.
• Ability to work in a fast-paced environment.
• Ability to adapt to changes.
• Ability to develop and maintain client relationships.
• Previous work experience in a fast-paced environment requiring strong multi-tasking and problem-solving skills.

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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