Description

This position follows a hybrid schedule with 3 - 4 In-office days per week. Our office is located at 131 Morristown RD, Basking Ridge, NJ, 07920.

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.

Follow up of outstanding A/R for all payers and/or including self-pay and/or including resolution of denials. This position is responsible for handling all correspondence related to an insurance or patient account, contacting insurance carriers, patients and other facilities as needed to attain maximum reimbursement on accounts and identify issues or changes to achieve client profitability. Ability to research and resolve accounts appearing on Delinquent Insurance Report, Collection Ledger and Government Payor report as directed by management making appropriate decisions on accounts to be worked to maximize reimbursement.

This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm EST.

We offer 4 weeks of paid on-the-job training and the hours during training will be 8:00 am - 5:00 pm EST, Monday - Friday.

Primary Responsibilities:

• Work under the daily supervision of the Operations A/R Supervisor/Manager
• Effectively work with the client and staff to improve billing operations
• Assist patients with questions ad inquiries
• Validate insurance and other billing information
• Review Medical Records to validate date of service, servicing provider and other basic non-clinical data
• Assist in identifying current and/or potential billing issues specific to outstanding receivable
• Follow up on denied or unadjudicated encounters
• Protect/observe patient confidentiality per policies and procedures
• Meet productivity standards as based on internal operational and client goals
• Enter free form notes/status codes onto patient accounts ensuring adequate documentation for any activity performed on the account through billing, follow-up, or processing of correspondence
• Review and prepare claims for manual and/or electronic billing submission. This includes submitting corrected claim and appeals.
• Correct any identified billing errors and resubmit claims to insurance carrier. Follow up on payment errors, low reimbursement, denials, etc.
• Complete third party contractual and/or regulatory adjustments and write offs as indicated on the explanation of benefits and/or third-party correspondence.
• Use appropriate systems for payment determination and resolution.
• Maintain a current working knowledge of all healthcare related issues and regulations.
• Act responsibly with patients, co-workers, management, and clients. Maintain a professional attitude.
• Demonstrate knowledge of proper, safe, efficient usage of current office equipment/software
• Assist in other duties assigned as they arise

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions 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 medical billing experience
• 2+ years of experience with effectively interacting with physicians, patients, and other staff members
• Intermediate level of proficiency with Microsoft Word, Excel and Outlook
• Knowledge of Out of Network billing and appeals
• Oral & written communication skills
• Ability to work full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm EST.

Preferred Qualifications:

• Medical billing and coding certification
• Knowledge of electronic medical records
• Working knowledge of New Jersey No-Fault & Workers Compensation billing and appeals

Telecommuting Requirements:

• Reside within commutable distance to the office at 131 Morristown RD, Basking Ridge, NJ 07920
• 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 $17.74 - $31.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

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.

OptumCare 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.

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

Requisition #: 2322665

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