Advanced Patient Account Specialist

Are you passionate about delivering exceptional patient care and making a meaningful impact in the healthcare industry? Do you thrive in fast-paced environments where no two days are ever the same?

We're seeking a skilled Advanced Patient Account Specialist to join our team at UnitedHealth Group. As a key member of our organization, you will play a vital role in ensuring that patients receive timely and accurate payment for their medical services.

In this challenging and rewarding position, you will be responsible for performing complex or specialized collection activities. You will work closely with customers and healthcare insurance providers to determine the reason for payment delinquency, negotiate and advise on the collection of overdue bills, and take appropriate action to recover overdue payments. Your expertise will also be called upon to develop, implement, maintain, and manage organization policies on collections practices.

This is a dynamic opportunity to grow your career and make a lasting difference in the lives of our patients. If you're a motivated and results-driven professional who excels in a team environment, we encourage you to apply.

• You will communicate with internal partners, including client management, controllers, and managers, to inform them of next steps regarding outstanding or past due balances. Your strong communication skills and attention to detail will ensure seamless collaboration and efficient resolution of issues.
• Evaluate current collections processes and procedures to identify opportunities for improvement. Your analytical mind and problem-solving skills will help us optimize our operations and enhance patient satisfaction.
• Educate internal and external stakeholders, including patients, administrators, cash posters, physicians, and collectors, regarding collection activities and procedures. Your ability to articulate complex concepts in a clear and concise manner will facilitate effective knowledge transfer and compliance.
• Evaluate account information, such as invoice history, payment dates, and contact details, to determine payment issues, root causes, and trends. Your data analysis skills will help us identify areas for improvement and develop targeted solutions.
• Identify account issues that require escalation to senior leadership or internal partners for resolution. Your judgment and decision-making skills will ensure prompt attention to critical matters and minimize disruptions to our operations.
• Gather additional information from applicable systems to further investigate customer concerns or complaints. Your ability to navigate complex software systems and extract relevant data will support informed decision-making and enhanced patient care.
• Monitor daily workload and create work assignments for the team as needed. Your organizational skills and attention to detail will ensure efficient task management and optimal resource allocation.
• Act as a resource for colleagues and provide guidance on best practices, policies, and procedures. Your expertise and willingness to share knowledge will foster a culture of continuous learning and improvement.
• Record correspondence information within relevant PM systems, such as eClinical Works, Allscripts, and Athena. Your accuracy and attention to detail will ensure seamless tracking and reporting of interactions.
• Make phone calls to customers using relevant systems, such as Unity and Anywhere Connect, to request payment for services. Your excellent communication skills and empathy will build trust and rapport with customers, promoting positive outcomes and minimizing conflicts.
• Communicate potential solutions or available services to external customers through various channels, including emails, phone calls, and written correspondence. Your creative approach to problem-solving and ability to adapt to different communication styles will help us deliver personalized support and exceed customer expectations.
• Perform necessary follow-up to ensure timely resolution of appeals, obtain updated insurance information, identify and correct billing errors, and more. Your dedication to delivering exceptional patient care and meeting deadlines will drive results and promote a culture of accountability.
• Receive and/or process credit card payments and electronic funds transfers within applicable systems, such as Velocity. Your technical skills and attention to detail will ensure secure and efficient transactions, protecting sensitive customer data and preventing financial losses.
• Transfer payment information to internal partners, like Cash Posting Department, to ensure accurate application to customer accounts. Your organizational skills and attention to detail will streamline processes and minimize errors.
• Respond to customer requests for negotiated payment plans or processes. Your empathetic approach and creative problem-solving skills will help us develop tailored solutions that meet individual needs and promote long-term success.
• Seek approval from relevant stakeholders, such as management, to negotiate balance payoff and/or payment terms beyond standard authority levels and guideline limits. Your professionalism, diplomacy, and business acumen will ensure seamless negotiation and successful outcome.
• Perform collection activities on assigned work files, adhering to department procedures and best practices. Your expertise and adherence to policies will protect patient rights and interests while driving operational efficiency.
• Create and distribute correspondence, including emails, dunning letters, system-generated letters, and invoices, to inform customers of required actions, such as reminders of payments due or final demands for payments. Your writing skills and attention to detail will ensure clear, concise communication and minimize misunderstandings.
• Manage delinquency suppressions for external customers to send accurate notifications and correspondence. Your organizational skills and attention to detail will prevent oversights and ensure timely communication.
• Maintain up-to-date knowledge of CPT and ICD-10 codes, required modifiers, and encounter data. Your commitment to ongoing education and staying abreast of industry developments will ensure compliance and enhance patient care.
• Maintain current awareness of Medicare and Medicaid laws, HCFA requirements, contractual arrangements, and other third-party payer regulations. Your diligence and dedication to regulatory compliance will safeguard patient rights and interests.
• Apply knowledge of third-party payer guidelines when reviewing denied claims to ensure proper use of modifiers and CPT/ICD-10 codes. Your analytical skills and attention to detail will drive accurate claims processing and minimize disputes.
• Demonstrate understanding of relevant software applications, including Excel, Outlook, Access, and Word. Your technical skills and adaptability will enable seamless integration with existing systems and support data-driven decision-making.
• Comply with Health Insurance Portability and Accountability Act (HIPAA) standards when handling patients' protected health information (PHI). Your commitment to confidentiality and data security will safeguard patient trust and well-being.
• Perform additional duties as assigned. Your flexibility and willingness to take on new challenges will support the growth and evolution of our organization.
• Meet department productivity standards. Your ability to prioritize tasks, manage time effectively, and maintain focus under pressure will drive operational efficiency and excellence.