Insurance Representative

2 months ago

Brockton, Massachusetts, United States Optum Full time

Opportunities at Optum, in strategic partnership with Allina Health. As an Optum employee, you will provide support to the Allina Health account. 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.

This position is responsible for the management of activities relative to third party payer billing. Ensures timely and accurate filing of claims, performs accounts receivable management, and follows up on denials and non-payments. May assist in the training and mentoring of other team members.

If you are located in MN or WI, you will have the flexibility to work remotely as you take on some tough challenges.

Primary Responsibilities:

  • Insurance billing follow up in compliance with government rules and regulations
  • Submits, processes, and resolves claim rejections and denials
  • Verifies patient insurance eligibility for denial resolution
  • Completes the appeal process
  • Monitors and follows up on unpaid balances
  • Resolves issues and resubmits for payment
  • Utilizes resources to reconcile accounts
  • Performs demographic and insurance coverage updates on accounts and bills new insurance
  • Contacts insurance companies to obtain the status of outstanding claims and submitted appeals
  • Provides professional billing support
  • Assists in training and mentoring to ensure compliance of established processes
  • Provides education or feedback to operational sites and other departments within Revenue Cycle Management (RCM)
  • Participates in process improvement initiatives to improve efficiencies and customer service expectations
  • Monitors, identifies, and communicates trend analysis
  • Other duties as assigned

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:

  • 2+ years of experience in revenue cycle operations
  • 2+ years of experience in medical accounts receivable
  • 1 + years of experience in billing follow up and denials
  • 1+ years of experience with Epic

Preferred Qualifications:

  • 2+ years of experience with medical terminology and medical coding

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

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.

#RPO

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