Collections Representative - San Juan, PR

UnitedHealth Group • PR

89d

About The Position

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. As a Collections and/or Billing Representative, 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 resolving claims. Bring your listening skills, emotional strength, and attention to detail as you work to ensure every claim has an accurate, fair, and thorough review.

Requirements

• 6+ months of experience in collections, billing or healthcare claims
• Demonstrated ability using computer and Windows PC applications, which includes strong keyboard and navigation skills and ability to learn new computer programs
• Experience with Microsoft Tools: Microsoft Word (creating memos, writing), Microsoft Outlook (setting calendar appointments, email) and Microsoft Excel (creating/editing spreadsheets, filtering, navigating reports)
• Ability to work 40 hours / week during standard business operating hours Monday - Friday from 8:00am – 8:00pm AST. It may be necessary, given the business need, to work overtime or weekends
• Professional proficiency in both English and Spanish (bilingual)

Nice To Haves

• Certified Medical Coder
• Experience in accounts receivable, insurance and/or healthcare
• Experience processing medical claims
• Experience working in a fast-paced environment
• Medical terminology acumen
• Medicare/Medicaid knowledge

Responsibilities

• 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 payer portals to verify eligibility, claim status and/or to obtain better claim insight information
• Works directly from our main system to review and resolve claims for accurate resolution
• Review and research denied claims by navigating multiple systems, to accurately capture data/information for accurate processing
• Monitor outstanding balances within accounts and take appropriate actions to ensure clients pay as billed
• Manage the preparation of invoices and complete reconciliation of billing with accounts receivable
• Communicate and collaborate with Patient Access or other back-end departments to ensure clear understanding on claims errors/issues and trends, using clear and simple language
• Conduct data entry and re-work for adjudication of claims
• Responsible for maintaining access to payor portals current and secure
• Work on multiple simultaneous projects as needed
• Work with PHI standards, and electronic health record access compliance
• Meet the performance goals established for the position in the areas of efficiency, accuracy, quality, client satisfaction and attendance
• Complete outbound calls as needed to payors for claim status
• Other duties may apply

Benefits

• Comprehensive benefits and career development opportunities

What This Job Offers

• Job Type: Full-time
• Number of Employees: 5,001-10,000 employees