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Collections Representative - National Remote

Company: UnitedHealth Group
Location: Las Vegas
Posted on: September 12, 2023

Job Description:

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
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. -

This position is full-time, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:30am - 5:30pm CST. It may be necessary, given the business need, to work occasional overtime or weekends.
We offer weeks of paid training. The hours during training will be discussed. Training will be conducted virtually from your home.
*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Primary Responsibilities: -

  • Follows up on pharmacy PBM invoices submitted to Health Plans to ensure prompt / timely payment and escalate issues as necessary -
  • Evaluates payments / denials received for correctness and ensures they are applied appropriately -
  • Creates 1st level appeals and assist with payer projects -
  • Identifies bad debt write-offs and A/R adjustments. Initiates write-off and adjustments in accordance with policies and procedures -
  • Ensures secondary bills and patient invoices are accurately generated and submitted on a timely basis -
  • Identifies any overpayments and / or duplicate payments, with investigation and resolution. Processes refund requests in accordance with policies and procedures -
  • Develop relationships with payers to obtain claim requirements and resolve root causes -
  • Identify issues/trends and escalate to Supervisor / Manager when assistance is needed -
  • Adheres to Regulatory / Payor Guidelines and policies & procedures -
  • Provides exceptional customer service to internal and external customers -
  • 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:

    • High School Diploma / GED (or higher) -
    • 1+ years of experience with pharmacy adjudication or pharmacy claim collections OR 1+ years OptumRx / Optum Pharmacy / NDC experience -
    • Basic experience with Microsoft Excel -
    • Ability to work any 8-hour shift during normal business hours of 7:30am - 5:30pm CST, Monday - Friday

      Preferred Qualifications:

      • Intermediate experience with Microsoft Office products including Microsoft Excel, Word, Outlook, Teams -
      • Specialty Pharmacy experience
      • Knowledge of NDC, ICD-10, and HIPAA -

        Telecommuting Requirements:

        • Ability to keep all company sensitive documents secure (if applicable)
        • Required to have a dedicated work area established that is separated from other living areas and provides information privacy
        • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

          California, Colorado, Connecticut, Nevada, New Jersey, New York, Washington or Rhode Island Residents Only: The salary range for California / Colorado / Connecticut / Nevada / New Jersey / New York / Washington / Rhode Island residents is $16.00 - $31.44. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.
          #RPO #GREEN

Keywords: UnitedHealth Group, Las Vegas , Collections Representative - National Remote, Accounting, Auditing , Las Vegas, Nevada

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