Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together.
As part of the UnitedHealth Group family of businesses, we're a dynamic new partnership formed by Dignity Health and Optum. We'll count on your professionalism, expertise, and dedication to help ensure that our patients receive the quality of care they need. So, if you're looking for a place to use your passion, your ideas and your desire to drive change, this is the opportunity for you.
The Billing Representative is responsible for accurate and timely billing of UB-04 claims for acute hospital services. This role works closely with internal teams and hospital facilities to resolve claim edits, ensure compliance with CMS, State, and Payer regulations, and follow established billing matrices and workflows to support clean claim submission and optimal reimbursement.
This position is full-time (40 hours/week), Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00am - 3:30pm PST. It may be necessary, given the business need, to work occasional overtime.
We offer on-the-job training. The hours of training will be aligned with your schedule.
Primary Responsibilities:
- Prepare, review, and submit UB-04 claims for acute inpatient and outpatient hospital services
- Review and resolve claim edits by sending and responding to tasks in accordance with established processes
- Work directly with hospital facilities to obtain required documentation, clarify billing issues, and resolve discrepancies
- Follow detailed billing matrices, payer-specific instructions, and internal workflows
- Ensure all billing activities remain compliant with payer guidelines and internal compliance standards
- Identify and correct billing errors prior to claim submission to prevent denials
- Assist with claim follow-up, rebilling, and correction requests as needed
- Document all account activity clearly and accurately in billing systems
- Collaborate effectively with team members to meet department goals and deadlines
- Maintain productivity and accuracy standards in a high-volume acute care environment
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
- Must be 18 years of age OR older
- 1+ years of hospital billing experience
- Working knowledge of medical terminology
- Familiarity with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
- Experience with Microsoft Word (create correspondence and work within templates), Microsoft Excel (data entry, sort / filter, and work within tables) and Microsoft Outlook (email and calendar management)
- Ability to work Monday - Friday, 7:00am - 3:30pm PST
Preferred Qualifications:
- Experience with UB-04 billing
- Residing within PST time zone
- Experience with Federal or State billing
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.
Soft Skills:
- Experience with identifying root causes to determine appropriate actions and outcomes
- Ability to completely and concisely summarize important details in account notes
- Ability to multitask, handling multiple software's at a time
- Ability to conduct professional conversations with internal and external teams
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.98 - $32.12 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
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.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Top Skills
What We Do
We’re the health care technology and innovation company of the UnitedHealth Group enterprise along with UnitedHealthcare. We’re a global organization that’s evolving health care so everyone can have the opportunity to live their healthiest life. With our hands across all aspects of health, we'll provide you with a rewarding career that enables you to grow in the directions that best fit your passions. This is your opportunity to be part of a team that’s dedicated to Caring. Connecting. Growing together.
Our global technology team consists of more than 30,000 innovators from around the world passionate about using technology to improve the lives of people and communities. We are modernizing the health care system through modern analytics, comprehensive clinical expertise, innovative technologies and extensive experience in improving operational and clinical performance.
As part of our team, you will be provided opportunities to channel your curiosity into initiative, working alongside distinguished engineers and developers pursuing innovations that improve the health care experience for everyone. We encourage you to dive in, explore and ask questions about creative ways to use technology to help make the health care system work like an actual system.
Gallery
Optum Offices
Hybrid Workspace
Employees engage in a combination of remote and on-site work.
Optum has three workplace models that balance the needs of the business, the responsibilities of a job, and your preference for more flexibility. These models are core on-site 5 days/week, hybrid 3 day/s week and telecommute or fully remote.