Collections Representative

Optum; Hyderabad; On-site; INR 450,000 - 750,000; Full time

Job summary

Optum in Hyderabad is seeking a Collections Representative to manage accounts receivable within the client-focused revenue cycle. The role requires AR calling experience, with emphasis on physician and hospital billing, denials, and HIPAA compliance.

The candidate will analyze claims, coordinate with payers and clients, and drive process improvements while ensuring timely completion of tasks and accuracy across the AR lifecycle.

Qualifications

• Graduate (10+2+3) or Btech and MBA with AR experience.
• 18+ months of experience in AR calling.
• Hands-on experience in both physician and hospital billing.
• Solid knowledge of denial management within the RCM/AR domain.
• Solid knowledge of medical insurance (HMO, PPO, Medicare, Medicaid, private payers).
• Familiar with workflows and the applications used in AR processes.

Responsibilities

• Review outstanding insurance balances to identify and resolve issues preventing finalization of claim payment.
• Analyze data and trend to improve first-pass denial rates and reduce AR aging.
• Act as AR specialist with understanding of the accounting cycle/claim lifecycle.
• Ensure all workflow items are completed within set turnaround times and quality expectations.
• Analyze EOBs and denials at claim level and identify trends for process improvements.
• Perform other duties as assigned.

Skills

AR experience

Denial Management

Physician Billing

Hospital Billing

Communication skills

HIPAA knowledge

MS Office proficiency

Analytical thinking

Education

Graduate degree

B.Tech

MBA

Tools

MS Office

Excel

Outlook

Job description

Improve the lives of others while Caring. Connecting. Growing together.

Job Description - Collections Representative (2378233)

Collections Representative - 2378233

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.

The AR Associate is responsible for the accounts receivable aspects of the client-focused revenue cycle operations and must display in-depth knowledge of and execute all standard operating procedures (SOPs) as well as communicating issues, trends, concerns and suggestions to leadership.

Eligibility: Graduate with 18+ months of experience in AR Calling, including both Physician Billing and Hospital Billing where Hospital Billing is mandatory and should have experience in Denial Management within the RCM/AR domain.

Primary Responsibilities:

• Review outstanding insurance balances to identify and resolve issues preventing finalization of claim payment, including coordinating with payers, patients and clients when appropriate
• Analyze and trend data, recommending solutions to improve first pass denial rates and reduce age of overall AR
• Accounts Receivable Specialist that has an "understanding" of the whole accounting cycle / claim life cycle
• Ensure all workflow items are completed within the set turn-around-time within quality expectations
• Be able to analyze EOBs and denials at a claim level in addition they should find trends impacting dollar and leading to process improvements
• Perform other duties as assigned
• Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so

Required Qualifications:

• Graduate (10+2+3) or Btech and MBA with AR experience
• 18+ months of experience in AR Calling
• Domain Expertise: Hands-on experience in both Physician and Hospital Billing
• Solid knowledge of Denial Management within the RCM/AR domain
• Solid knowledge of medical insurance (HMO, PPO, Medicare, Medicaid, Private Payers)
• In-depth working knowledge of the various applications associated with the workflows

Knowledge / Skills / Abilities:

• Solid knowledge and use of the American English language skills with neutral accent
• Ability to communicate effectively with all internal and external clients
• Ability to use good judgment and critical thinking skills; ability to identify and resolve problems
• Proficient in MS Office software; particularly Excel and Outlook
• Efficient and accurate keyboard/typing skills
• Solid work ethic and a high level of professionalism with a commitment to client/patient satisfaction
• Functional knowledge of HIPAA rules and regulations and experience related to privacy laws, access and release of information

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.

UnitedHealth Group is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need special assistance or accommodation for any part of the application process, please call 1-866-566-8715 to be connected to Recruitment Services. Recruitment Services hours of operation are 7 a.m. to 7 p.m. CT, Monday through Friday.

UnitedHealth Group is a registered service mark of UnitedHealth Group, Inc. The UnitedHealth Group name with the dimensional logo, as well as the dimensional logo alone, are both service marks for the UnitedHealth Group, Inc.

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.