Collections Representative

UnitedHealth Group - Phoenix, AZ3.6

Full-timeEstimated: $28,000 - $40,000 a year
Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.

Combine two of the fastest - growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making Healthcare data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life’s best work.SM

Primary Responsibilities:
Ensure all claims are billed and received by the payers for proper adjudication. This includes timely processing of allocated volume of accounts, based on established production guidelines and time parameters provided for workflow
Responsible for outbound calls and / or status inquiries via payers website validating receipt of medical claims and adjudication status within established timeframes
Display competent ability to access, navigate, and manage account information through phone calls and payer websites
Work any edits and denials in allocated workflow to achieve proper adjudication to payment. This includes, but is not limited to: verify insurance is correct, update insurance demographics, rebill claims not received, document the status of work performed, follow - up on outstanding adjudication items according to departmental guidelines, and is also responsible for billing secondary / tertiary claims along with providing supporting documentation to payers for additional payment
Perform scheduled follow up on accounts to include calls to payers and / or patients, as well as accessing payer websites, and resolving complex accounts with minimal or no assistance necessary
Effectively resolve complex or aged inventory, including payment research and payment recoups with minimal or no assistance necessary
Document all work and calls performed, in accordance to policy. This includes complete contact information, good grammar, and expected outcomes
Obtain primary and / or secondary EOB and claims to bill next responsible payer, along with utilizing various internal resources to obtain medical records to respond to requests from payers upon request
Accurately and thoroughly documents the pertinent collection activity performed
Maintain assigned worklists and resolve high priority and aged inventory
Identify and communicate issues to leadership, including payer, system or escalated account issues for timely resolution

Required Qualifications:
High School Diploma / GED (or higher) OR 10+ years equivalent working experience
2+ years of experience in Healthcare billing or healthcare Collections experience in a provider setting
Ability to navigate Microsoft products; Microsoft Word (creating and editing documents) and Microsoft Excel (create spreadsheets, pivot tables and formulas, data entry, reviewing reports, sort / filter and open / edit / saving documents)
Understanding of medical terminology, diagnosis codes, denial codes, ICD10 Codes and calculating fee scheduled
Understanding of UB's and Remittance Advise (RA's)
Ability to read and understand EOB's (Explanation of Benefits)

Preferred Qualifications:
1+ years’ experience Hospital Billing or Hospital Collections
Experience in interpreting Payer Contracts and determining accurate payments on patient accounts
Experience to know the appropriate questions to ask when calling insurance agencies to get the necessary information to move forward in resolving the claim
Ability to have a solid understanding of hospital claims and processes in order to review and analyze claims and account receivable functions
Able to identify trends when working claims and communicate this to their Supervisor timely for quick resolution

Soft Skills:
Ability to “think outside the box” to recommend innovative solutions
Highly motivated and able to work independently, comfortable with ambiguity
Ability to remain focused and productive each day though tasks may be repetitive
Ability to learn new products, services, procedures and support systems
Ability to effectively prioritize and multi - task in high volume workload situations
Careers with Optum360. At Optum360, we're on the forefront of health care innovation. With health care costs and compliance pressures increasing every day, our employees are committed to making the financial side more efficient, transferable and sustainable for everyone. We're part of the Optum and UnitedHealth Group family of companies, making us part of a global effort to improve lives through better health care. In other words, it's a great time to be part of the Optum360 team. Take a closer look now and discover why a career here could be the start to doing your life's best work.SM

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.