Careers at UnitedHealth Group
We’re creating opportunities in every corner of the health care marketplace to improve lives while we’re building careers. At UnitedHealth Group, we support you with the latest tools, advanced training and the combined strength of high caliber co-workers who share your passion, your energy and your commitment to quality. Join us and start doing your life’s best work.SM
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.
Optum’s Pacific West region is redefining health care with a focus on health equity, affordability, quality, and convenience. From California, to Oregon and Washington, we are focused on helping more than 2.5 million patients live healthier lives and helping the health system work better for everyone. At Optum Pacific West, we care. We care for our team members, our patients, and our communities. Join our culture of caring and make a positive and lasting impact on health care for millions.
The Payment Entry Specialist works under general supervision to perform payment entry duties involving settlement of patient accounts and related clerical activities including posting patient and third party payments and adjustments; and balancing daily batches. The Payment Entry Specialist is responsible for maintaining a positive working relationship with patients, staff and third parties; representation of the organization in a professional manner; and, keeping the assigned supervisor apprised of work product/projects status on a routine basis.
You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Consistently exhibits behavior and communication skills that demonstrate Optum’s commitment to superior customer service, including quality, care and concern with each and every internal and external customer
Reviews encounter data forms for accuracy of CPT and ICD-10 codes, required modifiers, and other encounter data
Prints insurance claim forms
Maintains Claim Form log
Performs electronic claims submission
Maintains summary report notebooks and confirmation logs
Reviews insurance claim forms for accuracy and completeness
Makes necessary claims corrections
Sorts and reviews payments received by the Business Office
Calculates insurance contact adjustments
Prepares payments for data entry according to Payment Calculation policies and procedures
Applies knowledge of Medicare and Medic-Cal guidelines in reviewing claims to ensure appropriate use of modifiers and CPT/ICD-10 codes
Corrects claims appearing on edit reports
Maintains Edit Report binders
Communicates trends to department supervisors
Maintains working knowledge of general claims requirements and updates to ICD-10/CPT codes
Uses, protects, and discloses Optum patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
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 experience
1+ years of working in a general clerical in a medical setting
Ability to demonstrate solid proficiency using MS Suite and other systems
Professional working knowledge of CPT & Diagnosis Coding, Medical Terminology, and basic Anatomy
Preferred Qualifications:
CPC certificate
2+ years of medical billing and/or related job experience
1+ years of working in a healthcare setting
Bilingual
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.
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
