Billing Representative

4 weeks ago

Redlands, United States Optum Full time
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. 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.

Billing Representative will be responsible for a few work ques with insurance follow ups such as denials and resolve deniels, following up on claims with no status.

This position is full time. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00am - 4:00pm. It may be necessary, given the business need, to work occasional overtime. Our office is located at 10425 Enterprise Dr, Redlands, CA.

We offer 90 days of paid training. The hours during training will be 7:30am to 4:00pm, Monday - Friday. Training will be conducted onsite.

Primary Responsibilities:

The following are exemplary essential job duties and responsibilities and are not intended to represent an all-inclusive listing of related essential functions of the position.
  • Contacts insurance carriers/patients regarding outstanding insurance claims to obtain proper payment.
  • Prepares proper documentation for appeals to insurance carriers.
  • Ensures all accounts are set-up correctly in the computer using knowledge of A/R software, understanding of eligibility requirements and use of the internet.
  • Has thorough knowledge of insurance carrier procedures and processes.
  • Understands contract reimbursement rates for individual carriers/networks.
  • Processes refunds when applicable.
  • Responsible for investigating and correcting prepayments.
  • Must meet minimum production standards as set by management.
  • Responsible for a book of unpaid claims that appear in work queues assigned to each Billing Rep.
Other Work as Required/Requested:
  • May be assigned special projects or other assignments and work tasks that are generally within the scope and level of the position, and relative to the need for flexible company operations.
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 equivalent experience
  • Must be 18 years of age or older.
  • 1+ years of experience in medical insurance billing
  • Ability to work any of our 8-hour shift schedules during our normal business hours of 7:00am - 4:00pm.
Preferred Qualifications:
  • Medical Billing/Terminology.
  • 2+ years of experience in medical insurance billing.
  • Appropriate English usage, spelling, grammar, punctuation; knowledge of basic arithmetic concepts: ability to operate standard office machines; basic application of CPT's. Excellent telephone skills.
  • Ability to complete tasks in a timely and accurate manner; and compliance with department and organization policies and procedures.
  • Verbal/written communication and customer service skills.
  • Ability to successfully uphold the established customer service standards and company mission statement.
  • Knowledge of medical billing and coding systems; ability to assess work responsibilities and prioritize; keeping supervisors/managers apprised of status on a routine basis; and keen insight in problem solving relative to billing, in general.
  • Must be able to understand payer's procedures and policies as they pertain to payment of claims; be able to calculate proper reimbursement based on contracts; and have the ability to make critical decisions regarding resolution of claims.
Soft skills:
  • Work with a spirit of enthusiasm, teamwork, cooperation and a sense of urgency.
  • Maintain a high degree of confidentiality over all matters during business operations including patient and employee information.
  • Ability to multi-task in an efficient, thorough, and prioritized manner.
  • Good working knowledge and intermediate/advanced use of Word, Excel, and Internet.
  • Ability to work quickly, accurately and independently.
  • Ability to anticipate needs and solve problems.
  • Excellent written and verbal communication skills.
  • Promotes and exhibits outstanding customer service
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Washington, Rhode Island, OR Washington, D.C. Residents Only: The hourly range for this is $16.54 - $32.55 per hour. Pay is based on several factors including but not limited to local labor markets , education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable . In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

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 .

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