Senior Recovery / Resolutions Representative

UnitedHealth Group - Franklin, TN

Energize your career with one of Healthcare’s fastest growing companies.

You dream of a great career with a great company – where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it’s a dream that definitely can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.

This opportunity is with one of our most exciting business areas: Optum – a growing part of our family of companies that make UnitedHealth Group a Fortune 5 leader.

Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.

The PRS Recovery Representative works as a liaison regarding information about patient services and how those services are paid by investigating and pursuing recoveries through contact with various parties. The representative works directly with providers to recover overpayments through multiple communication methods including phone, email, fax and postal mail. Your job will be 2 fold with 20% customer service which will result in 80% collections. We offer the latest tools along with the most intensive training program in the industry and nearly limitless opportunities for advancement. This position also offers quarterly incentives based on performance.

Primary Responsibilities:
Provide claims expertise support by reviewing, researching, investigating, negotiating, and resolving all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities
Fundamental Execution: Plan, prioritize, organize and complete work to meet established production goals, quotas and deadlines in a fast pace and ever changing environment
Communicate professionally with the provider to ensure PRS is meeting the needs and expectations of the client; build a good rapport with the provider contacts by establishing professional working relationships to ensure timely recoveries
Analyze, identify trends, and provide inventory and or client updates as necessary
Must meet state and federal compliance policies, reimbursement policies, and contract compliance
Work independently while acting as a resource and mentor for others.
Perform other duties as assigned

Required Qualifications:
High school diploma / GED (or higher)
1+ years of claims, collections, or healthcare experience
1+ years of customer service with analyzing and solving customer problems
High proficiency with computer and Windows PC applications (ability to create, copy, send and save documents, and spreadsheets in Microsoft Word and Microsoft Excel)
Must be able to work a standard 40 hour work week 7:55am - 4:25pm Monday - Friday. It may be necessary, given the business need, to work occasional overtime or weekends

Preferred Qualifications:
Bachelor’s Degree (or higher)
Provider overpayment recovery experience
Professional billing or claims experience
Experience with negotiations and direct client interactions
Previous work within the community giving back or volunteering time and resources
Previous call center experience

Soft Skills:
Ability to work in a dynamic environment both independently and in a group setting
Strong direct and indirect communication skills

Physical Requirements and Work Environment:
Extended periods of sitting at a computer and use of hands/fingers across keyboard or mouse, speaking, listening using a headset.
Business office environment with moderate noise level due to Representatives talking, computers, printers, and floor activity
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health - related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do 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.

Keywords: Optum; Recovery; Resolutions; Collections; Billing; Customer Service; Claims