Healthcare Collection Representative Cebu

Optum Philippines; Cebu City; On-site; PHP 350,000 - 470,000; Full time

Job summary

Optum Philippines is seeking a skilled Collections for Healthcare unpaid claims professional to verify claim status, collect on unpaid balances, and coordinate with providers and insurers. This role emphasizes accuracy, policy knowledge, and timely dispute resolution within a provider-side environment.

The position requires college graduation, experience with medical billing/AR collections (12+ months), familiarity with UB claims/UB04 forms, and proficiency in Windows-based systems.

Qualifications

• College graduate.
• Experience on provider (hospital) side.
• Familiar with EPIC system is an advantage.
• Knowledge of UB Claims and UB04 forms.
• Proficiency with Windows PC applications.
• 12+ months background in medical billing/ AR collections.
• Experience calling insurance to verify claim status and payment disputes.
• Ability to multi-task across multiple products and benefits.

Responsibilities

• Process documents, emails, and calls for blended accounts.
• Perform tasks with moderate guidance in own function.
• Handle some work with limited established procedures.
• Complete basic tasks without review by others.
• Supervision required for higher-level tasks.
• Return to office setup (Makati Office).
• Read contracts to resolve payment disputes.
• Work on the Provider side to coordinate with insurers.
• Check with insurance to verify claim status and collect unpaid claims.
• Process claims payment.
• Comply with all company policies and procedures, including changes to work location, team assignments, and schedules.

Skills

Medical billing

AR collections

Payer calls

Multitasking

Windows proficiency

Education

College graduate

Tools

EPIC system

Job description

Job Description:

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.

This function is responsible for Collections for Healthcare unpaid claims. The position in this function interact with customers gathering support data to ensure invoice accuracy and also work through specific claims discrepancies. Provide input to policies, systems, methods, and procedures for the effective management and control of the premium collection function. Educate customers regarding the availability of receiving claims and remitting payments through online applications. Monitor outstanding balances and take appropriate actions to ensure clients pay as billed. Manage the preparation of invoices and complete reconciliation of billing with accounts receivables. May also include quality assurance and audit of collection activities.

Primary Responsibilities

• Blended Account process documents, emails and calls
• Moderate work experience within own function
• Some work is completed without established procedures
• Basic tasks are completed without review by others
• Supervision/guidance is required for higher level tasks
• Return to office set-up (Makati Office)
• Contract reading of payment dispute
• Working on the Provider side
• Checking with the insurance to verify claim status and collect unpaid claims
• Process claims payment
• Comply with all applicable Company policies, procedures, and business directives, including any changes relating to work location, team assignments, work schedules, and flexible work arrangements
  

Required Qualifications

• College Graduate
• Experience working on Provider side (hospital side)
• Used and familiar with EPIC SYSTEM is an advantage
• Familiar with UB Claims and has knowledge in UB04 forms
• Proficiency with Windows PC applications, which includes the ability to navigate multiple programs and learn new and complex computer system applications
• Proven background on medical billing/ AR Collections at least a minimum of 12mons
• Proven background in calling insurance (Payer) to verify claim status and payment dispute
• Proven ability to multi-task and to understand multiple products and multiple levels of benefits within each product
  

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.

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