Senior Recovery Resolution Specialist
3 weeks ago
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.
Key Responsibilities- Take inbound calls from healthcare providers and/or make outbound calls to discuss and resolve outstanding overpayments.
- Provide claims expertise support by reviewing, researching, investigating, negotiating, and resolving all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities.
- Plan, prioritize, organize and complete work to meet established production goals, quotas and deadlines in a fast-paced and ever-changing environment.
- Communicate professionally with the provider to ensure Optum is meeting the needs and expectations of the client; build a good rapport with the provider contacts by establishing professional working relationships to ensure timely recoveries.
- Evaluate, identify trends, and provide inventory and/or client updates as necessary.
- Must meet state and federal compliance policies, reimbursement policies, and contract compliance.
- Works independently while acting as a resource and mentor for others.
- High School Diploma / GED
- Must be 18 years of age or older
- 1+ years of healthcare customer service experience
- 1+ years of customer service with analyzing and solving customer problems
- High level of computer and Windows PC applications (ability to create, copy, send and save spreadsheets in Microsoft Excel)
- Ability to work onsite at Optum's office
- Ability to work normal business hours of 7:55 AM - 4:25 PM, Monday – Friday. It may be necessary, given the business need, to work occasional overtime or weekends
- 1+ years of claims or collections experience
- Provider overpayment recovery experience or debt collection
- Professional billing experience
- Experience with negotiations and direct client interactions
- Previous work within the community giving back or volunteering time and resources
- Previous call center experience
- Ability to work in a dynamic environment both independently and in a group setting
- Strong Communication and Customer Service skills
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