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 (40 hours / week), Monday – Friday. Employees are required to work any of our 8-hour shift schedules during our normal business hours of 7:00am – 7:00pm CST. It may be necessary, given the business need, to work occasional overtime.

We offer 4 – 8 weeks of paid training. The hours of the training will be based on assigned schedule or will be discussed on your first day of employment. Training will be conducted virtually from your home.

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

Primary Responsibilities:

• Review open AR and prioritize collection activities
• Develop relationships with payers to obtain remits and resolve root causes
• Assure that timely and accurate follow up activity is performed on all invoices
• Responsible for review and documenting of key accounts
• Identify issues / trends and escalate to Supervisor / Manager when assistance is needed
• Identify and document bad debt write – offs and A / R adjustments
• Identifies any overpayments and / or duplicate payments, with investigation and resolution
• Create refund requests, in accordance with policies and procedures
• Ensures secondary claims are accurately generated and submitted on a timely basis
• Evaluates payments / denials received for correctness and ensures they are applied appropriately
• Provide exceptional Customer service to internal and external customers
• Work with offshore partners to ensure that exceptions are being resolved within the designated standard
• Develop relationships with other departments to provide feedback about root cause issues.
• Adhere to Regulatory / Payer Guidelines and policies & procedures
• 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.

• High School Diploma / GED
• Must be 18 years of age or older
• 2+ years of major medical insurance collections OR home infusion billing experience
• Experience using Microsoft Word (edit, create & save documents)
• Microsoft Excel (editing spreadsheets)
• Microsoft Outlook (email)
• Microsoft Teams
• Ability to work full – time (40 hours / week), Monday – Friday. Employees are required to work any of our 8-hour shift schedules during our normal business hours of 7:00am – 7:00pm CST. It may be necessary, given the business need, to work occasional overtime

• Infusion Pharmacy experience
• Knowledge of NDC, ICD – 10, and HIPAA

• 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

• Reliable and consistent record of attendance
• Ability to follow complex processes and create solutions independently
• Strong problem-solving capabilities and time management within a fast-paced environment
• Ability to multi-task successfully and meet deadlines in fast-paced environment
• Demonstrate a willingness to listen, understand and acknowledge customers, co-workers, leadership and others in a collaborative, respectful and productive manner
• Demonstrate good judgement and professional initiative on all matters come across the desk, whether inside or outside the normal scope of the role