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 of 7:00am – 6:00pm EST. You may work overtime as needed by the business. Training will be conducted virtually from your home.
As a Billing Representative – Third Party you’ll play a critical role in creating a quality experience that impacts the financial well-being of our patients. You’ll be the expert problem solver as you work to quickly identify, analyze and resolve issues in a fast-paced environment. This is your chance to take your career to the next level as you support teams by reviewing and investigating claims. Bring your listening skills, emotional strength and attention to detail as you work to ensure every claim has a fair and thorough review.
- Multi-task and work independently and as part of a team.
- Demonstrate excellent communication, organization and problem solving
- Adapt to change in a fast-paced environment
- Join a cross functional focused team with many opportunities for cross-training and skill/career development
If selected for this position, it is required that you successfully complete the UnitedHealth Group new hire training and demonstrate proficiency to continue in the role.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Primary Responsibilities:
- Analyzes and applies denials to third party carriers in all media types.
- Complies with departmental Business Rules and Standard Operating Procedures
- Focuses efforts on decreasing the Accounts Receivable, increasing cash, and/or reducing bad debt.
- Interprets explanation of benefits for appropriate follow up action.
- Utilizes automation tools to verify eligibility, claim status and/or to obtain better billing information.
- Creates worklist through Access database and manipulate data to analyze for trends and resolve claims for adjudication.
- Reviews and researches denied claims by navigating multiple computer systems and platforms, in order to accurately capture data/information for processing.
- Communicates and collaborates with members or providers to evaluate claims errors/issues, using clear, simple language to ensure understanding.
- Conducts data entry and re-work for adjudication of claims.
- Works on various other projects as needed.
- Meets the performance goals established for the position in the areas of: efficiency, accuracy, quality, patient and client satisfaction and attendance.
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) OR equivalent work experience
- Ability using computer and Windows PC applications including the ability to learn new and complex computer system applications – instant message, video conferencing
- Experience with Microsoft Outlook (setting calendar appointments, email) and Microsoft Excel (creating spreadsheets, filtering, navigating reports)
Preferred Qualifications:
- Some College level classes/coursework
- 1+ years of experience in A/R, Billing, and Customer Service, Insurance, or Healthcare
- Medical terminology acumen and experience
Telecommuting Requirements:
- 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 UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
Soft Skills:
- Strong keyboard and navigation skills and ability to learn new computer programs
- Ability to resolve calls, avoiding escalated complaints.
- Ability to exhibit empathy and be courteous to callers.
- Ability to triage and handle escalated situations.
- Ability to work in a fast-paced environment.
- Ability to adapt to changes.
- Ability to develop and maintain client relationships.
- Previous work experience in a fast paced environment requiring strong multi-tasking and problem solving skills