Collections Representative - Dignity Health - Remote in San Juan, PR

UnitedHealth Group

4d•Remote

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 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. As a Collections Representative for Dignity Health, 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. If you are located in San Juan, PR, you will have the flexibility to work remotely as you take on some tough challenges.

Requirements

6+ months of experience in collections, billing or healthcare claims
Experience using computer and Windows PC applications, which includes solid 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 9:30am - 6:30pm 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 Account receivable, Insurance and/or Healthcare
Experience processing medical claims
Experience working in a fast-paced environment
Medical terminology acumen
Medicare/Medicaid knowledge
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Responsibilities

Complies with departmental Business Rules and Standard Operating Procedures
Review and research insurance follow-up, and denied claims by navigating multiple systems simultaneously, such as payer portals, to accurately capture data/information for accurate processing
Comprehensively understand payer and state specific policies for claim resolution
Interprets explanation of benefits for appropriate follow up action
Prioritize aged accounts by discharge date, and collaborate with leadership to determine accounts on which to take action
Complete outbound calls as needed to payors for claim status
Focuses efforts on decreasing the accounts receivable, increasing cash, and/or reducing bad debt
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
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
Identify account issues that need to be escalated to senior leadership or internal partners, for resolution
Conduct data entry and re-work for adjudication of claims
Work on multiple simultaneous projects as needed
Meet the performance goals established for the position in the areas of efficiency, accuracy, quality, client satisfaction and attendance
This position is full-time (40 hours/week) with our site operating from Monday - Friday from 9:30AM - 6:30PM. It may be necessary, given the business need, to work occasional overtime and/or weekends or holidays
If selected for this position, it is required that you successfully complete the UnitedHealth Group new hire training and demonstrate proficiency to continue in the role
Other duties may apply