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. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life’s best work. SM

The Accounts Receivable Specialist 2 position in this function follows up on Motor Vehicle, Workers Compensation, and occasional commercial and government claims, both facility and professional, including phone calls, emails, faxes, writing appeals, providing any and all information needed to insurance carrier to process and pay the claim.

Follow up of outstanding A/R for all payers and/or including self pay and/or including resolution of denials. This position is responsible for handling all correspondence related to an insurance or patient account, contacting insurance carriers, patients and other facilities as needed to attain maximum reimbursement on accounts and identify issues or changes to achieve client profitability. Ability to research and resolve accounts appearing on Delinquent Insurance Report, Collection Ledger and Government Payor report as directed by management making appropriate decisions on accounts to be worked to maximize reimbursement.

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Work under the daily supervision of the Operations A/R Supervisor/Manager
• Effectively work with the client and staff to improve billing operations
• Assist patients with questions ad inquiries
• Validate insurance and other billing information
• Review Medical Records to validate date of service, servicing provider and other basic non-clinical data
• Assist in identifying current and/or potential billing issues specific to outstanding receivable
• Follow up on denied or unadjudicated encounters
• Protect/observe patient confidentiality per policies and procedures
• Meet productivity standards as based on internal operational and client goals
• Enter free form notes/status codes onto patient accounts ensuring adequate documentation for any activity performed on the account through billing, follow-up, or processing of correspondence
• Review and prepare claims for manual and/or electronic billing submission. This includes submitting corrected claim and appeals
• Correct any identified billing errors and resubmit claims to insurance carrier. Follow up on payment errors, low reimbursement, denials, etc.
• Complete third party contractual and/or regulatory adjustments and write offs as indicated on the explanation of benefits and/or third-party correspondence
• Use appropriate systems for payment determination and resolution
• Maintain a current working knowledge of all healthcare related issues and regulations
• Act responsibly with patients, co-workers, management, and clients. Maintain a professional attitude
• Demonstrate knowledge of proper, safe, efficient usage of current office equipment/software
• Assist in other duties assigned as they arise

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 (or higher) OR 7+ years of medical billing experience
• 5+ years of medical billing experience
• 2+ years of experience with Out of Network billing and appeals
• 2+ years of experience with effectively interacting with physicians, patients, and other staff members
• 2+ years of experience with insurance verifications
• Intermediate level of proficiency with Microsoft Word, Excel and Outlook

Preferred Qualifications:

• Medical billing and coding certification
• Knowledge of electronic medical records
• Working knowledge of New Jersey No-Fault & Workers Compensation billing and appeals

Soft Skills:

• Strong oral & written communication skills

Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

California, Colorado, Connecticut, Nevada, New York, Washington or Rhode Island Residents Only: The hourly range for California, Colorado, Connecticut, Nevada, Washington or New York City residents is $18.80 to $36.78. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

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.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

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

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