Job Description

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. 

We’re a dynamic partnership formed by Quest and Optum to combine our unique expertise. As part of the growing family of UnitedHealth Group, we’ll leverage our compassion, our talent, our resources and experience to bring financial clarity and a full suite of Revenue Management services to Healthcare Providers, nationwide.

As a Billing Representative - Third Party you’ll play a critical role in creating a quality experience that impacts the financial well-being of our patients. You’ll be the expert problem solver as you work to quickly identify, analyze and resolve issues in a fast paced environment. This is your chance to take your career to the next level as you support teams by reviewing, and investigating claims. Bring your listening skills, emotional strength and attention to detail as you work to ensure every claim has a fair and thorough review.

This position is full-time, Monday – Friday. Employees are required to work our normal business hours of 8:00am – 5:00pm. It may be necessary, given the business need, to work occasional overtime. Employees are required to work 2 days onsite and 3 days from home.

We offer 4 weeks of on-the-job training. The hours of the training will be aligned with your schedule.

If you are within commutable distance to the office at 400 Egypt Rd Norristown, PA you will have the flexibility to work from home and the office in this hybrid role* as you take on some tough challenges.

Primary Responsibilities:

• Analyzes and applies denials to third party carriers in all media types.
• Complies with departmental Business Rules and Standard Operating Procedures.
• Focuses efforts on decreasing the Accounts Receivable, increasing cash, and / or reducing bad debt.
• Interprets explanation of benefits for appropriate follow up action.
• Utilizes automation tools to verify eligibility, claim status and / or to obtain better billing information.
• Creates worklist through Access database and manipulate data to analyze for trends and resolve claims for adjudication.
• Reviews and researches denied claims by navigating multiple computer systems and platforms, in order to accurately capture data / information for processing.
• Communicates and collaborates with members or providers to evaluate claims errors / issues, using clear, simple language to ensure understanding.
• Conducts data entry and re - work for adjudication of claims.
• Works on various other projects as needed.
• Meets the performance goals established for the position in the areas of: efficiency, accuracy, quality, patient and client satisfaction and attendance.

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 of age OR Older
• 1 + years of experience in Billing or working within the healthcare industry
• Ability using computer and Windows PC applications, which includes strong keyboard and navigation skills and ability to learn new computer programs
• Experience with Microsoft Word (create correspondence and work within templates), Microsoft Excel (data entry, sort / filter, and work within tables) and Microsoft Outlook (email and calendar management)
• Ability to work onsite at 400 Egypt Rd, Norristown, PA 19403 up to two days per week. Employees are required to work 2 days onsite and 3 days from home
• Ability to work our normal business hours of 8:00am – 5:00pm, Monday - Friday. It may be necessary, given the business need, to work occasional overtime

Preferred Qualifications:

• Medical terminology acumen
• Previous experience with medical claims processing

Telecommuting Requirements:

• Reside within commutable distance to the office at 400 Egypt Rd Norristown, PA
• 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
• If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group - approved symptom screener. When in a UnitedHealth Group building

Soft Skills:

• Ability to resolve calls, avoiding escalated complaints
• Ability to exhibit empathy and be courteous to callers
• Ability to triage and handle escalated situations
• Ability to work in a fast-paced environment
• Ability to adapt to changes
• Ability to develop and maintain client relationships
• Previous work experience in a fast-paced environment requiring strong multi-tasking and problem-solving skills

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you’ll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.74 - $31.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

#RPO #RED

Job Tags

Hourly pay, Minimum wage, Full time, Work experience placement, Local area, Remote job, Home office, 2 days per week, Monday to Friday,

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