Job Description

This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together.

As part of the UnitedHealth Group family of businesses, we're a dynamic new partnership formed by Dignity Health and Optum We'll count on your professionalism, expertise, and dedication help ensure that our patients receive the quality of care they need. So, if you're looking for a place to use your passion, your ideas and your desire to drive change, this is the opportunity for you.

This position is full-time Monday - Friday. Employees are required to have flexibility to work any of our shift schedules during our normal business hours of 8:00am - 4:30pm MST. It may be necessary, given the business need, to work occasional overtime.

This will be on the job training and the hours during training will be during normal business hours.

Primary Responsibilities:

• Handle escalated and complex facility insurance claims, helping to provide resolution and settlement of account
• Contacts insurances through a variety of methods (e-mail, form letters, web portals, and phone calls) to discuss, negotiate payment and resolve outstanding medical bill accounts and balances
• Sends detailed appeals to dispute insurance denials
• Perform research on various computer systems and document claim information regarding current status, payment expectations, notes of conversations and other relevant information
• Reconciles, balances and pursues account balances and payments
• Use mail, email and phones to contact insurance companies to discuss and resolve outstanding medical bill accounts and balances
• Obtain agreement on potential balance payoff and/or payment terms within stated level of authority and guideline limits
• Prepare and submits reports to internal management for escalation of outstanding medical bills
• Performs additional responsibilities as needed.

This is a challenging role that requires providing best in class service to our customers during their times of difficulty. It's a fast-paced environment that requires focus and ability to multi-task throughout the day.

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
• 1+ years of hospital/facility follow up collections experience
• 1+ years of experience managing hospital/facility appeals and denied claims, including navigating insurance payer portals to investigate, resolve, and secure reimbursement for denied hospital claims
• Experience reviewing and reading UB-04 claim forms
• Knowledge of and experience with medical terminology
• Proficient with Microsoft Office Suite - including Microsoft Excel (create, copy, edit, send and save spreadsheets), Microsoft Word (create, copy, edit, send and save documents), and Microsoft Outlook (create, edit, share, save)
• Ability to work Monday - Friday, 08:00AM - 04:30PM MST

Preferred Qualifications:

• 2+ years of experience working in healthcare insurance
• Experience with Medicaid/Medicaid Managed Payers
• Working knowledge of ICD-10 and CPT/HCPCS

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

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

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $18 - $32 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

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 volume of applicants.

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 an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

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

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