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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
Primary Responsibilities:
- Review outstanding insurance balances to identify and resolve issues preventing finalization of claim payment; including coordinating with payers, patients and clients when appropriate
- Analyze and trend data, recommending solutions to improve first pass denial rates and reduce age of overall AR
- Ensure all workflow items are completed within the set turn-around-time within quality expectations
- Be able to analyze EOBs and denials at a claim level in addition they should find trends impacting dollar and #'s, leading to process improvements
- Perform other duties as assigned
- Comply with all applicable Company policies, procedures, and business directives, changes including those relating to work location, team assignments, work schedules, and flexible work arrangements
Required Qualifications:
- Graduate
- 12+ months and above experience in healthcare accounts receivable (Denial Management)
- Accounts Receivable Specialist that has an "understanding" of the whole accounting cycle / claim life cycle
- Functional knowledge of HIPAA rules and regulations and experience related to privacy laws, access and release of information
- In-depth working knowledge of the various applications associated with the workflows
- Solid knowledge of medical insurance (HMO, PPO, Medicare, Medicaid, Private Payers)
- Solid knowledge and use of the American English language skills with neutral accent
- Proficient in MS Office software; particularly Excel and Outlook
- Proven ability to communicate effectively with all internal and external clients
- Proven ability to use good judgment and critical thinking skills; ability to identify and resolve problems
- Proven efficient and accurate keyboard/typing skills
- Demonstrated solid work ethic and a high level of professionalism with a commitment to client/patient satisfaction
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.
Skills Required
- Graduate degree or completion of graduate-level education
- At least 12 months of healthcare accounts receivable or denial management experience
- Understanding of the accounting cycle and healthcare claim lifecycle
- Functional knowledge of HIPAA rules, privacy laws, and information access and release requirements
- Working knowledge of applications associated with healthcare revenue-cycle workflows
- Knowledge of medical insurance, including HMO, PPO, Medicare, Medicaid, and private payers
- American English proficiency with a neutral accent
- Proficiency with Microsoft Office, especially Excel and Outlook
- Effective communication with internal and external clients
- Good judgment, critical thinking, problem-solving, and issue-resolution skills
- Efficient and accurate keyboarding and typing skills
- Strong work ethic, professionalism, and commitment to client and patient satisfaction
Optum Compensation & Benefits Highlights
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Leave & Time Off Breadth — PTO is generally described as decent or good, and many note it as a strong part of the package. Actual ability to take time off can depend on workload and team coverage.
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Retirement Support — Offerings include a 401(k) with employer match and access to an employee stock purchase plan, which are highlighted as meaningful components of total rewards. These programs are consistently referenced among core benefits.
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Parental & Family Support — Parental and caregiver leave, along with adoption assistance, are publicly highlighted and viewed as notable elements of the package. Availability can be role-specific, but these supports contribute to overall breadth where offered.
Optum Insights
What We Do
Optum, part of the UnitedHealth Group family of businesses, 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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. At Optum, we support your well-being with an understanding team, extensive benefits and rewarding opportunities. By joining us, you’ll have the resources to drive system transformation while we help you take care of your future. We recognize the power of connection to drive change, improve efficiency and make a difference in health care. Join a team where your skills and ideas can make an impact and where collaboration is key to creating technology that produces healthier outcomes.
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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 and the responsibilities of each role. These models, core on‑site (5 days/week), hybrid (4 days/week) and telecommute or fully remote, vary by country, role and location.
