Walk-in | Collections Representative

Optum; Hyderabad; On-site; INR 300,000 - 540,000; Full time

Job summary

Optum is a global health services organization seeking an AR Associate to manage client-focused revenue cycle operations. The role focuses on reviewing insurance balances, resolving issues, and improving denial rates.

Strong knowledge of medical insurance and HIPAA, plus MS Office proficiency, are essential for accurate, timely cash posting. Candidates should have 18+ months in healthcare AR and at least 1 year of hospital billing experience.

Qualifications

• 18+ months of healthcare accounts receivable experience
• 1+ year hospital billing experience
• Solid knowledge of medical insurance (HMO, PPO, Medicare, Medicaid, private payers)
• Experience with HIPAA rules and privacy laws
• Proficient in MS Office, especially Excel and Outlook
• Strong communication and problem-solving abilities
• Accurate keyboard skills and professional work ethic

Responsibilities

• Review outstanding insurance balances to resolve issues preventing payment
• Analyze data trends to improve denial rates and reduce aging AR
• Understand the full accounts receivable and claim life cycle
• Ensure all workflow items meet turnaround times and quality expectations
• Analyze EOBs and denials to identify trends and drive process improvements
• Perform other duties as assigned
• Adhere to employment contracts and company policies

Skills

Communication

HIPAA knowledge

MS Office

Typing speed

Problem solving

Education

Graduate (10+2+3)

Tools

Excel

Outlook

MS Office

Job description

Role & responsibilities

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.

Description - External

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.

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
• Able to analyze EOBs and denials at a claim level in addition they should find trends impacting dollar and #'s, 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

Qualifications - External

Required Qualifications:

• Graduate (10+2+3)
• 18+ months and above experience in healthcare accounts receivable required (Denial Management) 1+ Years of experience as Hospital Billing
• 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
  • Functional knowledge of HIPAA rules and regulations and experience related to privacy laws, access and release of information
  • Proficient in MS Office software; particularly Excel and Outlook
  • Proven ability to communicate effectively with all internal and external clients
  • Proven ability to use good judgment and critical thinking skills; ability to identify and resolve problems
  • Proven to be efficient and accurate keyboard/typing skills
  • Proven solid work ethic and a high level of professionalism with commitment to client/patient satisfaction.