Hybrid Billing Representative - Las Vegas, Nv

If you are in Las Vegas, you will have the flexibility to work from home and the office in this hybrid role* 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.

TheBilling Representative is responsible for the validation of charge data received from the clinic settings, creation and submission of complete and accurate claims, follow-up on claims status, payment accuracy, appeals and correspondence.

This position is full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00am – 4:30pm. It may be necessary, given the business need, to work occasional overtime.

Our office is located at 2716 N Tenaya Way, Las Vegas, NV. Employees will be required to work 3 days onsite and 2 days from home.

We offer 5 days of paid training. The hours during training will be 8:00am to 4:30pm, Monday - Friday. Training will be conducted onsite.

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

Primary Responsibilities:

• Accept imported charges from clinics and complete the data elements for accurate 1500 claim form data.
• Apply specialty clinic edits as appropriate such as NDCs, lab values and modifiers.
• Follow-up on claims status and unpaid encounters using payer portals, contacting insurance plans at specific intervals to ensure claims are paid timely and accurately.
• Will submit corrected claims, reconsiderations and appeals via payer portals or paper as required.
• Respond to insurance correspondence received by various methods such as fax, mail, email.
• Contact clinics, coding, and other resources to assist with denials related to medical necessity, eligibility, authorizations, and diagnosis.
• Will submit appeals for payments according to payer requirements.
• Contact patients as appropriate to obtain information needed to update insurance information or provide information regarding coverage issues and coordination of benefits.
• Review encounters for payment demand letters and process bad debt files as appropriate.
• Complete address updates from electronic update files

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 old OR older
  
• 1+ years of experience in medical billing including Claims Status, claim appeals/reconsiderations, charge entry, payment entry or AR follow-up.
• 1+ years of experience working with and understanding of ICD10 and CPT coding – including modifiers.
• Knowledge of the 1500 form data elements, EOB reason codes, remarks codes and claims edits as well as NCDs and LCDs
• Basic computer skills to include Microsoft Outlook, Microsoft Word, and Microsoft Excel
• 1+ years of experience working as Accounts Receivable Clerk, Medical Biller, Insurance Follow-Up Representative Accounts Receivable Manager, or accountant.
• Understanding of collections processes, reimbursement methodologies, state, and federal guidelines for compliant billing practices
• Ability to work our normal business hours of 8:00am – 4:30pm. It may be necessary, given the business need, to work occasional overtime.

Preferred Qualifications:

• Medicare and/or Medicaid billing experience
• Understanding of requirements for billing procedures, drugs, drug waste and office-based labs.
• Familiarity with medical terminology
• Ability to calculate expected reimbursement, co-pays, and deductibles.
• Experience in using electronic claims editing systems and clearinghouse.

Telecommuting Requirements:

• Reside within commutable distance of 2716 N TENAYA WAY, Las Vegas, NV
• 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:

• High degree of accuracy and attention to detail
• Verbal and written communications skills to communicate with providers, payers, and others in a clear and professional manner.

Nevada Residents Only: The hourly range for Nevada 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.

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