[Hiring] Insurance Follow Up Representative @UnitedHealth Group

Role Description

This position is Remote in Pacific Standard Time Zone or Mountain Standard Time Zone. You will have the flexibility to work remotely as you take on some tough challenges.

The Business Services department is seeking an Insurance Follow Up Representative to join their team full-time. The Insurance Follow Up Representative serves the patients, clinicians, and staff of Optum by obtaining payment on outstanding receivables timely. Focus is upon resolving any issues that may be causing delay of payment, including:

• Contacting payers and using appropriate websites to determine claim status.
• Investigation and resolution of denied claims.
• Identification of trends and payer behavior contributing to inaccurate or delayed reimbursement.

Primary responsibilities include:

• Contacting insurance carriers/patients regarding outstanding insurance claims.
• Knowledge of clinic operating policies to help in the identification of denial root causes.
• Preparing proper documentation for appeals to insurance carriers.
• Processing the appealing of claims reimbursed incorrectly by payors.
• Ensuring all accounts are set up correctly in the computer.
• Maintaining knowledge of insurance carrier procedures and processes.
• Understanding contract reimbursement rates for individual carriers/networks.
• Examining documents for accuracy and completeness.
• Meeting minimum production and quality standards as set by management.
• Managing assigned worklist and following standard work to resolve claims.
• Maintaining Over 90 aging quality measures as determined by payer baselines and expectations.
• Other tasks as assigned.

This position is full-time, Monday - Friday. Employees are required to have flexibility to work any of our shift schedules during our normal business hours of 7:00 am - 3:30 pm PST. It may be necessary, given the business need, to work occasional overtime.

We offer on-the-job training. The hours of the training will be aligned with your schedule or will be discussed on your first day of employment.

Qualifications

• High School Diploma / GED OR equivalent work experience.
• Must be 18 years of age OR older.
• 2+ years of experience in Insurance follow up (Denial follow up, appeals reconsiderations).
• Experience in appeals writing and processing.
• 2+ years working knowledge of EOB, COB, Remits, and CMS 1500.
• Working knowledge of CPT & Diagnosis Coding, Medical Terminology, and basic Anatomy.
• Knowledge of medical insurance (plans, processes, requirements).
• Experience with computers and Windows PC applications.
• Ability to work full-time, Monday - Friday.

Requirements

• CPC Certification (preferred).
• Multi-specialty clinic experience (preferred).
• Epic experience (preferred).
• Experience working with Medicare and Medicare Advantage (preferred).

Telecommuting Requirements

• Reside within Pacific Standard Time Zone or Mountain Standard Time Zone.
• Ability to keep all company sensitive documents secure.
• Required to have a dedicated work area established that is separated from other living areas.
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection.

Benefits

• Comprehensive benefits package.
• Incentive and recognition programs.
• Equity stock purchase.
• 401k contribution (all benefits are subject to eligibility requirements).

Application Deadline

This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected.