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 Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00am - 3:30pm PST. It may be necessary, given the business need, to work occasional overtime. We offer 4 weeks of on-the-job training. The hours of the training will be aligned with your schedule. You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Educates and trains other follow up staff as needed. + Perform research on various computer systems and document customer information regarding current status, payment expectations, notes of conversations and other relevant information + Use mail, email and phones to contact customers to discuss, negotiate payment 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 on status of outstanding medical bills and proposed/planned payment settlement details + Identifies and analyzes underpayments to determine the reasons for discrepancies and processes denials and appeals; examines claims to ensure payers are complying with contractual agreements. + Address all inappropriate denials and underpayment by writing an effective and concise Provider Dispute Resolution + Monitors and reviews denial reason codes and underpayments to identify root causes; works with payer + contracting and other areas of the revenue cycle if necessary to resolve issues. Notes denial trends and informs supervisor/manager of findings to mitigate future claim rejections. + Participates in Contracting/Payer JOC’s as appropriate. + Maintains a thorough understanding of federal and state regulations as well as specific commercial payer requirements in order to promote compliant in billing and follow-up. + Keep current on all commercial payer updates including contract languages, rates, policies and payer updates/ changes. Keep Supervisor/Manager informed of any potential impact to current billing and reimbursement. + Identifies compliance risk and proactively recognize and rectify any issues to prevent commercial payers audit + Collaborates with other departments to identify, correct, and resolve issues to reduce denials and improve collections. + Utilize Government and Commercial regulatory guidelines for collection of outstanding accounts. + Follow appropriate appeal process on denials, ensuring resolution. + As appropriate, reviews, investigates and resolves missed payments or credit balances. + Initiate appropriate adjustments, insuring all necessary actions have been performed with the correct adjustment and amount. + Responds to patient concerns and/or complaints on a routine basis and keeps departmental leaders apprised of recurring issues. + Provide individual contribution to the overall team effort of achieving the department AR goal. + Identify opportunities for system and process improvement and submit to management + Other duties 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 OR equivalent work experience + Must be 18 years of age OR older + 3+ years of physician billing follow-up/collection experience + 2+ years of knowledge with Medicare and Medicare managed care contracts and appeal process + 1+ years experience with specialty follow up accounts, including but not limited to Oncology, OBGYN, Cardiology, etc. + 1+ years experience with EPIC + 1+ years experience and knowledge of PC application, including Microsoft Office Suite (Microsoft Excel, Microsoft Word, Microsoft PowerPoint and Microsoft Outlook) + 1+ years of experience in a related environment (i.e. office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools + Basic knowledge of Medical terminology + Ability to work full-time between 7:00am – 3:30pm PST **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 privacya + 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:** + Good written and verbal communication skills *All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy. The hourly range for this role is $28.61 to $56.06 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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. **_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._ \#RPO #RED