Hybrid Senior Collections Representative - San Rafael, CA - UnitedHealth Group

If you are in San Rafael, CA you will have the flexibility to work from home and the office in this hybrid role* 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 - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours between 5:30am - 8:30am PST. It may be necessary, given the business need, to work occasional overtime.

We offer 90 days of paid training. The hours of training will be based on your schedule or will be discussed on your first day of employment.

Our office is located at 3950 Civic Center Drive San Rafael, CA. Employees will be required to work some days onsite and some days from home

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

Primary Responsibilities:

• Correction of claims, based on personal knowledge and system identified errors to assure claims are submitted accurately

• Performs timely follow up with the payer to determine status of claim and processing of the payment

• Utilizing personal skills developed, performs timely follow up through phone calls, investigative work, re-bills and on-line applications to assure accounts are resolved in a timely and efficient manner

• Responsible for maintaining current and ongoing knowledge of State and Federal guidelines as they pertain to the accurate resolution of accounts

• Responsible for reviewing the Expected Payment variance reports for incorrect payments on accounts

• Responsible for all accounts assigned to assure the hospital receives accurate and timely payment

• Ability to manage work flows to assure accounts are not lost due to timely billing and other preventable errors

• Identified underpayments are reviewed to determine the reasons and appropriate actions taken to correct the discrepancies.  These actions may include, but not be limited to phone calls, appeal letters, working with the attending MD and HIM

• Identifies specific problems or trends, develops appropriate tracking tools, and keeps Manager and Director informed

• Responsible for handling all levels of questions and issues from insurance companies, appropriate governmental agencies, patients, and doctor’s offices

• Responsible for maintaining productivity within overall established Business Office guidelines.  All variances in overall productivity will be evaluated and corrective action developed with Management

• Researches and completes credit/charge corrections and write-offs

• Handles all written correspondence addressed to their area

• Utilizes the Hospital Information system to research accounts in a timely and effective manner

• Maintains copies of appeals and correspondence either at workstation, cash folders or personal filing systems.  Copies must be maintained in alphabetic order by year of service

• Correspondence could include: arbitration appeals for Managed Care, 1st report of injuries, follow up letters specific to claims and carriers, ABN’s, and TAR’s

• Participates actively in the achievement of organizational and departmental goals

• Attends and participates in in-services and staff meetings.  Maintains standards of the organization and department

• Abides by hospital policies on attire, work habits and relationships.  Observes confidentiality and decorum in conversation and behavior

• Assists in the orientation of new employees

• Other duties as assigned

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:

• 2+ years of experience pursuing/collecting reimbursement and reviewing accounts to determine next steps, including outreach to insurance companies and managing appeals

• 2 + years of medical office or hospital business office experience including billing/account collections for non-Government (private) health insurance, Other Government, Medicare and Medi-(excluding dental experience)

• Proficiency with Windows PC applications, which includes the ability to navigate multiple programs and learn new and complex computer system applications

• Ability to work/train onsite until productivity goals are met

• Must be 18 years of age or older

• Ability to work a 40-hour schedule within the operating hours of the site

• Ability to work 8 hours shift starting between 5:30am – 8:30am PST

Preferred Qualifications:

• Working knowledge of all areas related to the resolution of non-Government and/or Government accounts and the regulatory requirements for each payer

• Experience in Medicare, Medi-Cal, HMO, PPO, Work Comp, County or Champus etc.,

Telecommuting Requirements:

• Reside within commutable distance to the office in San Rafael, CA

• 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.

Soft Skills:

• Ability to work tactfully and professionally with patients, family members, hospital staff, medical staff, outside payers and vendors

• Ability to problem solve, multitask efficiently, organize, and prioritize multiple tasks with minimum supervision

• Run outstanding balance reports and research, collect or re-bill when appropriate

• Strong verbal and written communication skills are critical when working with payers (May need to initiate written appeals for contract discrepancies and underpayments)

• Understanding of the overall diversity of our patient population and treating everyone with respect and courtesy

• Comprehension of commercial payer reimbursement to determine contract compliance and payment performance

• Has thorough knowledge of Coordination of Benefits relative to primary versus secondary payers according to contractual and governmental guidelines

  
  

California Residents Only: The hourly range for California residents is $18.80 - $36.78 per hour. 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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