Collections Representative - Pharmacy

UnitedHealth Group • Dallas, TX

77d • $17 - $31

About The Position

This position is National Remote. You'll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges. 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 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 position is full-time (40 hours/week). Employees are required to work any of our 8-hour shift schedules during our normal business hours of 7:00am - 7:00pm CST, Monday - Friday. It may be necessary, given the business need, to work occasional overtime or weekends. We offer 4 - 8 weeks of on-the-job training. The hours during training will be 7:00am - 7:00pm CST, Monday - Friday. Training will be conducted virtually from your home.

Requirements

• High School Diploma / GED
• Must be 18 years of age OR Older
• 1+ years of Pharmacy billing/collections OR Home infusion billing experience
• Experience using Microsoft Word (edit, create & save documents)
• Experience using Microsoft Excel (editing spreadsheets)
• Experience using Microsoft Outlook (email)
• Experience using Microsoft Teams
• Ability to work any of our 8-hour shift schedules during our normal business hours of 7:00am - 7:00pm CST, Monday - Friday. It may be necessary, given the business need, to work occasional overtime or weekends

Nice To Haves

• Infusion Pharmacy experience
• Knowledge of NDC, ICD - 10, and HIPAA
• Knowledge of benefits verification and prior authorization
• Knowledge of explanation of benefits (EOB)

Responsibilities

• Review open AR and prioritize collection activities.
• Develop relationships with payers to obtain remits and resolve root causes.
• Assure that timely and accurate follow up activity is performed on all invoices.
• Responsible for review and documenting of key accounts.
• Identify issues / trends and escalate to Supervisor / Manager when assistance is needed.
• Identify and document bad debt write - offs and A / R adjustments.
• Identifies any overpayments and / or duplicate payments, with investigation and resolution.
• Create refund requests, in accordance with policies and procedures.
• Ensures secondary claims are accurately generated and submitted on a timely basis.
• Evaluates payments / denials received for correctness and ensures they are applied appropriately.
• Provide exceptional Customer service to internal and external customers.
• Work with offshore partners to ensure that exceptions are being resolved within the designated standard.
• Develop relationships with other departments to provide feedback about root cause issues.
• Adhere to Regulatory / Payer Guidelines and policies & procedures.
• Other duties as assigned.

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Insurance Carriers and Related Activities
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees