Collections Representative

UnitedHealth Group • Minneapolis, MN

11h • $18 - $32 • Remote

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 Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together.
As part of the UnitedHealth Group family of businesses, we’re a dynamic new partnership formed by Dignity Health and Optum. We’ll count on your professionalism, expertise, and dedication help ensure that our patients receive the quality of care they need. So, if you’re looking for a place to use your passion, your ideas and your desire to drive change, this is the opportunity for you.
This position is full-time, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 5:00pm CST. It may be necessary, given the business need, to work occasional overtime.
This will be on the job training and the hours during training will be normal business hours, Monday - Friday.

Requirements

• High School Diploma / GED
• Must be 18 years OR older
• 1+ years of hospital / facility collections experience, including follow‑up, appeals, and denied claims
• 1+ year of recent experience in follow-up with Medicare, Medicare Managed Care plans, Medi-Cal, or Medi-Cal Managed Care plans, including handling appeals and denials
• Experience navigating within an insurance portal to work denied hospital claims to resolution
• Experience reviewing and reading UB-04 claim forms
• Proficient in Microsoft Office Suite - including Microsoft Word, Microsoft Excel, and Microsoft Outlook
• Ability to work Monday - Friday, 8:00am - 5:00pm CST

Nice To Haves

• Experience with follow up on Medi-Cal or Medi-Cal Managed Care
• Working knowledge of ICD-10 and CPT/HCPCS

Responsibilities

• This position performs collecting, reconciliation, research, correspondence, and independent problem solving
• Reconciles complex, multi-payment accounts
• Submits appeal letters on underpaid claims as directed
• Interprets payer contracts to determine if payment and adjustment is accurate
• Reviews EOB's for denials, along with posting corrected adjustments in order to balance accounts
• Identifies needs for process improvements and creating/enhancing processes in the PFS department
• Promotes positive teamwork within department and among employees
• Works with all hospital departments for proper coding and billing procedures
• Follows all departmental, hospital, and regulatory policies and procedures, including HIPAA requirements
• Utilizes top customer service skills with all customers: patients, government agencies and commercial insurances
• Reconciles accounts on a daily basis to determine underpayment, overpayment or contractual adjustment correction
• May be assigned to process payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications, and/or payment plans in an accurate and timely manner, meeting goals in work quality and productivity
• Coordinates with other staff members and physician office staff as necessary ensure correct processing
• Reconciles, balances, and pursues account balances and payments, and/or denials, working with payor remits, facility contracts, payor customer service, provider representatives, spreadsheets and the company’s collection/self-pay policies to ensure maximum reimbursement
• May be assigned to research payments, denials and/or accounts to determine short/over payments, contract discrepancies, incorrect financial classes, internal/external errors
• Makes appeals and corrections as necessary
• Builds strong working relationships with assigned business units, hospital departments or provider offices
• Identifies trends in payment issues and communicates with internal and external customers as appropriate to educate and correct problems
• Provides assistance to internal clients
• Responds to incoming calls and makes outbound calls as required to resolve billing, payment and accounting issues
• Provides assistance and excellent customer service to patients, patient families, providers, and other internal and external customers
• Works as a member of the patient financial services team to achieve goals in days and dollars of outstanding accounts. Reduces Accounts Receivable balances
• Uses systems to document and to provide statistical data, prepare issues list(s) and to communicate with payors accurately
• Works independently under general supervision, following defined standards and procedures
• Uses critical thinking skills to solve problems and reconcile accounts in a timely manner
• External customers include all hospital patients, patient families and all third-party payers
• Internal customers include facility medical records and patient financial services staff, attorneys, and central services staff members

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED