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UnitedHealth Group Collections Representative - Rancho Cordova, CA in RANCHO CORDOVA, California

Combine two of the fastest - growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making Healthcare data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life’s best work.SM

The Collections Representative is responsible for supporting the back - end insurance follow - up function for several COEs across the United States. Reporting directly to the Credit Supervisor, the primary goal of the Collections Representative is to complete tasks relating to the resolution of insurance and patient credits associated with hospital accounts receivables. The primary responsibility is to ensure that credits for hospitals and patients are applied accurately and in a timely manner and in accordance with Government and payor regulations.

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. This is a 40 hour, full time role working flexible shifts, sometimes including evenings or Saturdays. We require our employees to be flexible enough to work any shift, any day of the week during those hours.

Primary Responsibilities:

  • Reviews all accounts on which credit balances exist and determines reason for the credit balance

  • Identifies accounts on which contractual adjustments are incorrect by working the daily credit balance report

  • Works with supervisor in identifying contract modeling problems which create credit balance accounts

  • Responds to third party inquiries and works to resolve circumstances that create unwarranted credit balances

  • Maintains all refund documentation in accordance with internal audit requirements

  • Within scope of job, requires critical thinking skills, decisive judgment and the ability to work with minimal supervision

  • Complies with all government and third - party payers regulatory mandated requirements for billing and collections

  • Ability to maintain confidentiality of all information under HIPPA guidelines

  • Meets departmental productivity and quality standards in time - frame given upon completion of training

Required Qualifications:

  • High School Diploma / GED (or higher)

  • Availability to work Mondays - Fridays with occasional Saturdays. 8 hour shift between the hours of 7:30am - 5:30pm

  • 1+ year experience with Medicare or Medicare Advantage Plans

  • 2+ years experience in healthcare collections environment

Preferred Qualifications:

  • 1+ years of back end revenue cycle experience in a facility and hospital setting

  • Experience and working knowledge of UB - 04 claim forms

  • Experience with hospital patient accounting systems

  • Understanding of the entire revenue cycle process

  • Basic knowledge of Revenue and ICD coding language

Soft Skills:

  • Ability to execute processes efficiently and maintain highest level of quality

  • Demonstrates ability to identify and communicate issues

  • Enhanced communication and customer service skills

  • Ability to be self - directed, coupled with exemplary time management skills and the ability to simultaneously manage multiple tasks

  • Must be able to work in a stressful environment

Careers with OptumInsight. Information and technology have amazing power to transform the Healthcare industry and improve people's lives. This is where it's happening. This is where you'll help solve the problems that have never been solved. We're freeing information so it can be used safely and securely wherever it's needed. We're creating the very best ideas that can most easily be put into action to help our clients improve the quality of care and lower costs for millions. This is where the best and the brightest work together to make positive change a reality. This is the place to do your life’s best work.SM

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Keywords: Optum, Rancho Cordova, CA, collections, health care, Medicare, hospital