Collections Representative

This position is Remote in MST or CST Time Zones, OR in one (1) of the following states: WA, OR, NV, MI, IN, OH, WV, PA, VT, ME, NH, MA, RI, CT, NJ, DE, MD, DC, VA, NC, SC, GA, or FL. You will have the flexibility to work remotely
* 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 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.

This function is responsible for accurate and timely follow – up of accounts receivables including researching, analyzing, and resolving unpaid Home Delivery Pharmacy medical claims. Positions in this function contact payers to determine reason for non-payment and take appropriate action to recover amounts due. Responsible for developing, implementing, maintaining, and managing organization policies on collection practices.

This position is full time, Monday – Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 6:30am – 4:00pm CST. It may be necessary, given the business need, to work occasional overtime. We offer weeks of on-the-job training. The hours of the training will be aligned with your schedule.

• Review open AR and prioritize medical claim activities
• Develop relationships with payers to obtain claim requirements and resolve root causes
• Assure that timely and accurate follow up activity is performed on all claims that are not paid within 45 days of submission
• Responsible for review and documenting of key accounts
• Identify issues / trends and elevate to Supervisor / Manager when assistance is needed
• Provide exceptional Customer service to internal and external customers
• Develop relationships with other departments to provide feedback about root cause issues
• Adhere to Regulatory / Payer Guidelines and policies & procedures
• 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.

• High School Diploma / GED OR equivalent work experience
• Must be 18 years of age OR older
• 1 years of experience with medical claim billing or collections OR pharmacy claim billing or collections
• 1 years of experience with working in Microsoft Office suite, specifically Microsoft Word (create, copy, edit, send, and save documents),
• Microsoft Excel (create, copy, edit, send, and save spreadsheets), and Microsoft Outlook (create, copy, edit, send, and save emails)
• Must be available to work an 8-hour shift between 6:30 AM and 4:00 PM CST, Monday – Friday.

• Specialty Pharmacy experience
• Medicare B Billing or Collections experience
• Knowledge of NDC, ICD – 10, and HIPAA
• Intermediate skill level in Microsoft Excel (using filters, sorting, conditional formatting, basic formulas)

• Reside within the Mountain or Central Time Zones, OR in one (1) of the following states: WA, OR, NV, MI, IN, OH, WV, PA, VT, ME, NH, MA, RI, CT, NJ, DE, MD, DC, VA, NC, SC, GA, or FL
• 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)
• Must live in a location that can receive a United Health Group approved high-speed internet connection or leverage an existing high-speed internet service

* All employees working remotely will be required to adhere to United Health Group’s Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc.…