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SalaryOptum 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.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Schedule: Monday-Friday 8:00am to 4:30pm PST
Primary Responsibilities:
- Ensuring a positive experience throughout the denial process while employing excellent customer service skills
- Facilitate communication between the hospital facilities, clinical teams, payers & billing
- Fulfilling payer requests for clinical reviews, secondary reviews to overturn denials
- Becoming knowledgeable of payer assigned time frames
- Understanding specific payer Utilization Management details
- Collaborating and alerting facility Case Managers of:
- Additional payer needs
- Requests for concurrent or retrospective review
- Physician Advisor review
- Providing support in the denial process to ensure timely processing of denials followed by timely and accurate documentation
- Participating in denial management calls within RCM and with the facility solutioning for denial prevention and reduction
- Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Optum360’s Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior
- Other duties as needed and assigned by their Manager, Director and or Senior
What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:
- Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
- Medical Plan options along with participation in a Health Spending Account or a Health Saving account
- Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
- 401(k) Savings Plan, Employee Stock Purchase Plan
- Education Reimbursement
- Employee Discounts
- Employee Assistance Program
- Employee Referral Bonus Program
- Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
- More information can be downloaded at: http://uhg.hr/uhgbenefits
Required Qualifications:
- High School Diploma / GED (or higher)
- 2+ years of experience in an Acute Care Facility or Centralized Business Office performing one of various functions including Billing/Coding, Balance after insurance or self-Pay Collections, Appeals processing, Patient Access Department Patient Scheduling, Pre-Service/Financial Clearance, Registration, Financial Counseling, or other functions related to revenue cycle activities in a complex multi-site environment
- Beginner level of proficiency in Microsoft Office including Word (creating and editing documents), Excel (creating and editing spreadsheets), and Outlook (creating, sending and saving email)
- Basic knowledge of medical terminology
- Basic level of proficiency with data entry and typing
- Must be comfortable with using the internet in order to perform facility and payer research
Preferred Qualifications:
- Experience in Hospital Environment, Doctors Office, or Central Billing Office
- Experience working with Insurance Companies
- Thorough understanding of insurance benefits, policies, and procedures
Soft Skills:
- Must have effective verbal and written communication skills
- Must possess strong organizational skills
- Must be able to handle multiple priorities and projects simultaneously
- Must have excellent interpersonal and customer service skills
- Must be comfortable operating in a collaborative, shared leadership environment that encourages change engagement and participation, and open dialogue
- High sense of responsibility and accountability; Takes ownership and initiative
- Results-oriented with a focus on the end-goal and business results as the objective
- Ability to think and act; decisiveness, assertiveness, with ability to achieve results quickly
- Adaptable and flexible, with the ability to handle ambiguity and sometimes changing priorities
- Professional demeanor and positive attitude; customer service orientation
- Ability to learn, understands, and applies new technologies, methods, and processes
- Ability to be a self-starter and work independently and as a team to achieve a common goal
- Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Optum360 and our client organization(s)
- All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
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.
#Green, #RPO
