Opportunities at Optum, in strategic partnership with Allina Health. As an Optum employee, you will provide support to the Allina Health account. 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.
This team is responsible for hospital billing denials and follow up for HMO/PPO commercial payers, along with Worker's Compensation, Motor Vehicle and other various payer plans.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Hours:
- This position is full time (40 hours per week) Monday - Friday
- Ability to work Monday-Friday 6:00 a.m. - 6:00 PM
- Ability to train for the first six weeks Monday - Friday, 07:00AM - 04:30PM CST
- Flexible Schedule is available after the training period within business hours of Monday-Friday 6:00 a.m. - 6:00 p.m. CST
Primary Responsibilities:
- Accurate processing of facility claims
- Responsible for editing and adjusting of EDI claims
- Analyze and adjudicate claims to ensure accurate payment
- Meet Department Quality and Accuracy Standards
- Interfaces with other departments to obtain necessary information required for resolution of claims
- Advise management of any claim issues or inappropriate and/or incorrect billing
- Perform additional duties assigned by management
- Assist with projects geared to improve efficiency and cost savings
- Requests medical records to assist in appeals requests from health plans
- Uses, protects, and discloses our patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
- Evaluate and respond to all aspects of written billing inquiries, including but not limited to: billing insurances, and updating invoices
- Research, troubleshoot and resolve complex billing issues, taking all steps to resolve and ensure full resolution
- Maintain all Compliance and HIPAA regulations at all times
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:
- 2+ years of Accounts Receivable experience with denials & appeals
- 2+ years of experience working with multiple health insurance payers
- 2+ years of office experience in the healthcare industry
- 2+ years of experience working with medical terminology, healthcare claims & coding software
- 2+ years of data entry experience
- Intermediate proficiency with Microsoft Office applications, to include Microsoft Word, Microsoft Excel, Microsoft Outlook, Microsoft Teams, etc
- Ability to work any shift between the hours of 6:00 am - 6:00 pm CST
Preferred Qualifications:
- Experience working with appeals
- Experience with thorough navigation of Excellian/Epic Hyperspace Billing System
- Experience with thorough navigation of Change HealthCare Assurance Reimbursement Management claims system
*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
California, Colorado, Nevada, Connecticut, New York, New Jersey, Rhode Island, Hawaii, Washington, or Washington D.C Residents Only: The hourly range for California, Colorado, Nevada, Connecticut, New York, New Jersey, Rhode Island, Hawaii, Washington, or Washington D.C residents is $16.54 to $32.55 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
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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