Optum Remote Associate Collections Representative

Work Based At Home; New York (NY); Remote; USD 10,000 - 60,000; Full time

Job summary

Join a forward-thinking organization as an Associate Collections Representative, where you will play a vital role in ensuring accurate reimbursement from third-party payers. This position offers the chance to work remotely, providing flexibility while tackling challenges that directly impact health outcomes. You will engage in systematic reviews of accounts, address denials, and maintain compliance with regulations. With a commitment to diversity and inclusion, this company fosters a supportive environment for career growth and development. If you are passionate about making a difference and thrive in a dynamic setting, this role is for you.

Benefits

Comprehensive benefits package

Incentive and recognition programs

Equity stock purchase

401k contribution

Flexible work hours

On-the-job training

Qualifications

• 2+ years of experience in physician billing and follow-up.
• Knowledge of managed care contracts and appeal processes.

Responsibilities

• Perform daily reviews of unpaid and denied accounts.
• Communicate with payers to resolve payment variances.

Skills

Physician Billing

Follow-up/Collection

Managed Care Contracts

Microsoft Office Suite

EPIC

Medical Terminology

Education

High School Diploma/GED

Tools

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

Microsoft Outlook

Job description

Optum Remote Associate Collections Representative

December 13, 2024

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.

The Associate Collections Representative is responsible for all follow-up activities ensuring accurate reimbursement from third parties, or resolution of all assigned accounts in a timely manner. Additionally, this position assists and provides education to other staff when issues arise.

This position is full-time. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00 am – 3:30 pm PST, Monday – Friday. It may be necessary, given the business need, to work occasional overtime.

We offer 4 weeks of on-the-job training. The hours of the training will be aligned with your schedule.

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

Primary Responsibilities:

• Perform daily, systematic reviews of unpaid, underpaid, and denied accounts from the appropriate third-party payer source ensuring that all assigned accounts are paid and/or resolved in a timely manner.
• Address all inappropriate denials and underpayment by writing an effective and concise Provider Dispute Resolution.
• Identify and analyze underpayments to determine the reasons for discrepancies and process denials and appeals; examine claims to ensure payers are complying with contractual agreements.
• Communicate directly with payers to follow up on outstanding claims and resolve payment variances; respond to payer inquiries and concerns, and work to develop and maintain positive relationships with payers.
• Focus attention on payers with complex follow-up requirements, accounts with high dollar balances, aged accounts, denial trends, and other advanced follow-up scenarios.
• Note denial trends and inform supervisor/manager of findings to mitigate future claim rejections.
• Maintain a thorough understanding of federal and state regulations as well as specific commercial payer requirements in order to promote compliance in billing and follow-up.
• Keep current on all commercial payer updates including contract languages, rates, policies, and payer updates/changes.
• Keep Supervisor/Manager informed of any potential impact to current billing and reimbursement.
• Identify compliance risks and proactively recognize and rectify any issues to prevent commercial payer audits.
• Utilize Government and Commercial regulatory guidelines for collection of outstanding accounts.
• Follow appropriate appeal processes on denials, ensuring resolution.
• As appropriate, review, investigate, and resolve missed payments or credit balances.
• Initiate appropriate adjustments, ensuring all necessary actions have been performed with the correct adjustment and amount.
• Respond to patient concerns and/or complaints on a routine basis and keep departmental leaders apprised of recurring issues.
• Provide individual contribution to the overall team effort of achieving the department AR goal.

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.
• Must be 18 years of age or older.
• 2+ years of experience in physician billing and follow-up/collection.
• Knowledge of managed care contracts and appeal processes.
• Experience with and knowledge of personal computer applications, including Microsoft Office Suite (Microsoft Word, Microsoft Excel, Microsoft PowerPoint, and Microsoft Outlook).
• EPIC experience.
• Basic knowledge of medical terminology.
• Ability to work any of our 8-hour shift schedules during our normal business hours of 7:00 am – 3:30 pm PST, Monday – Friday. It may be necessary, given the business need, to work occasional overtime.

Telecommuting Requirements:

• Ability to keep all company sensitive documents secure (if applicable).
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.
• If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener.

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C., Maryland Residents Only: The hourly range for this role is $16.00 to $28.27 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to the volume of applicants.