Claims Representative Associate - National Remote

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
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.
This position is full-time (40 hours/week) Monday to Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 10:00am – 07:00pm EST.

• All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary Responsibilities

• Answers or makes inbound/outbound calls in a fast-paced environment; handles difficult situations while maintaining quality customer service and expected
• Meets productivity and accuracy standards as established by management
• Working correspondence, edits and aged account receivable and identifying problem accounts to CHC leadership
• Adheres to HIPAA, PCI, and Change Healthcare Policies and Procedures
• Working self-pay or insurance receivables and related payments for the client. Effectively work accounts receivable to optimize cash flow and to meet organizational financial goals and objectives
• Updating patient demographics and insurance information
• Accurately documents all follow-up activities pertaining to each specific account in the CHC Workflow tool(s) concisely, completely and/or takes action in the client system as directed
• Handles patient and insurance inquiries associated with specific patient accounts, including identification and resolution of billing discrepancies when reviewing the account
• Establishes budget plans or payment arrangements with established guidelines and policies
• Handles escalation calls/accounts as necessary and appropriately de-escalates call to ensure patient/client satisfaction
• Assisting other representatives with client and/or procedural related questions

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 (or higher)
• 1+ years of experience with patient information/claims system reimbursement processes
• 1+ years of medical revenue cycle experience
• Ability to work during our business hours of 10:00am – 07:00pm EST

Telecommuting Requirements

• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Ability to keep all company sensitive documents secure (if applicable)

Preferred Qualifications

• Knowledge and understanding of healthcare billing and collection practices and methodologies in an automated environment
• Working knowledge of insurances and general reimbursement types: PPO, HMO, Indemnity, Medicare, Medicaid, Workers’ Compensation

Soft Skills

• Ability to possess excellent customer service and communication skills along with good math skills, and the ability to read, understand and follow verbal and written instructions

Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.
California, Colorado, Connecticut, Nevada, Washington or New York, Rhode Island Residents Only: The salary range for California / Colorado / Connecticut / Nevada / Washington / New York / Rhode Island residents is $16.00 - $27.31.Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.
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.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
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