[Hiring] Collections Representative @UnitedHealth Group

Role Description

This position is National Remote. You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

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 6am - 5pm PST. It may be necessary, given the business need, to work occasional overtime.

This will be on the job training for the first month and the hours during training will be 6:00 AM to 2:30 PM PST, Monday through Friday.

Primary Responsibilities:

• Collecting, reconciliation, research, correspondence, and independent problem solving.
• Reconciles complex, multi-payment accounts.
• Submits appeal letters on underpaid claims as directed.
• Interprets payer contracts to determine if payment and adjustment is accurate.
• Reviews EOB's for denials, along with posting corrected adjustments in order to balance accounts.
• Identifies needs for process improvements and creating/enhancing processes in the PFS department.
• Promotes positive teamwork within department and among employees.
• Works with all hospital departments for proper coding and billing procedures.
• Follows all departmental, hospital, and regulatory policies and procedures, including HIPAA requirements.
• Utilizes top customer service skills with all customers: patients, government agencies and commercial insurances.
• Reconciles accounts on a daily basis to determine underpayment, overpayment or contractual adjustment correction.
• May be assigned to process payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications, and/or payment plans in an accurate and timely manner, meeting goals in work quality and productivity.
• Coordinates with other staff members and physician office staff as necessary to ensure correct processing.
• Reconciles, balances, and pursues account balances and payments, and/or denials, working with payor remits, facility contracts, payor customer service, provider representatives, spreadsheets and the company’s collection/self-pay policies to ensure maximum reimbursement.
• May be assigned to research payments, denials and/or accounts to determine short/over payments, contract discrepancies, incorrect financial classes, internal/external errors.
• Makes appeals and corrections as necessary.
• Builds strong working relationships with assigned business units, hospital departments or provider offices.
• Identifies trends in payment issues and communicates with internal and external customers as appropriate to educate and correct problems.
• Provides assistance to internal clients.
• Responds to incoming calls and makes outbound calls as required to resolve billing, payment and accounting issues.
• Provides assistance and excellent customer service to patients, patient families, providers, and other internal and external customers.
• Works as a member of the patient financial services team to achieve goals in days and dollars of outstanding accounts. Reduces Accounts Receivable balances.
• Uses systems to document and to provide statistical data, prepare issues list(s) and to communicate with payors accurately.
• Works independently under general supervision, following defined standards and procedures.
• Uses critical thinking skills to solve problems and reconcile accounts in a timely manner.

Qualifications

• High School Diploma / GED
• Must be 18 years of age OR older
• 1+ years of hospital/facility collections experience, including follow‑up, appeals, and denied claims
• 1+ years of recent experience in follow-up with Medicaid Managed or Medi-Cal Managed Care plans, including handling appeals and denials
• Experience navigating within an insurance portal to work denied hospital claims to resolution
• Experience reviewing and interpreting UB 04 claim forms, including CPT, ICD 10, and HCPCS
• Experience with Microsoft Office Suite – including Microsoft Word, Microsoft Excel, and Microsoft Outlook
• Ability to complete training during the first month between 6:00 AM to 2:30 PM PST, Monday through Friday
• Ability to work an 8-hour shift, Monday through Friday, between 6:00 AM and 5:00 PM PST

Preferred Qualifications

• 2+ years of experience with follow-up on Medi-Cal or Medi-Cal Managed Care

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 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

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution (all benefits are subject to eligibility requirements)
• Hourly pay for this role will range from $18 - $32 per hour based on full-time employment

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.