Healthcare isn't just changing. It's growing more complex every day. ICD - 10 Coding replaces ICD - 9. Affordable Care adds new challenges and financial constraints. Where does it all lead? Hospitals and Healthcare organizations continue to adapt, and we are vital part of their evolution. And that's what fueled these exciting new opportunities.

Who are we? OPTUM360. We're a dynamic new partnership formed by DIGNITY HEALTH and OPTUM to combine our unique expertise. As part of the growing family of UNITEDHEALTH GROUP, we'll leverage our compassion, our talent, our resources and experience to bring financial clarity and a full suite of Revenue Management services to Healthcare Providers, nationwide. If you're looking for a better place to use your passion, your ideas and your desire to drive change, this is the place to be. It's an opportunity to do YOUR LIFE'S BEST WORK.SM

PRIMARY RESPONSIBILITIES:

• Responsible for the accurate processing and completion of medical claims.
• Process claims that route out of automatic adjudication, within current turnaround standards.
• Proficiency in product lines applicable to processing unit.
• Understand and apply plan concepts to include: Deductible, co-insurance, co-pay, and State variations
• Recognize issues related to variable deductible, coordination of benefits, carve-out and alternate benefits.
• Process correspondence and requests for reconsideration within time service standards.
• Use pre-approved electronic letters as well as handwritten letters to communicate with customers, providers, attorneys, regulators and other external entities.
• Adhere to quality improvement initiatives.
• Demonstrate increasing productivity to meet minimum requirements while maintaining quality standards.
• Special projects as required.

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)
• Ability to create and edit professional documents in Microsoft Word
• Ability to input data and review spreadsheets in Microsoft Excel
• Ability to review and create professional emails in Microsoft Outlook
• Previous medical billing experience OR successful completion of a certified medical billing program
• Working knowledge of insurance carrier policies and procedures
• Ability to work Monday - Friday, 8:00 am - 4:30 pm with some flexibility; ability to work overtime as business needs arise

PREFERRED QUALIFICATIONS:

• Previous experience working in an Accounts Receivable department

PHYSICAL REQUIREMENTS AND WORK ENVIRONMENT:

• Frequent speaking, listening using a headset, sitting, use of hands / fingers across keyboard or mouse, handling other objects, long periods working at a computer
• Service center environment with moderate noise level due to Representatives talking, computers, printers, and floor activity

CAREERS WITH OPTUMINSIGHT. Information and technology have amazing power to transform the Healthcare industry and improve people's lives. This is where it's happening. This is where you'll help solve the problems that have never been solved. We're freeing information so it can be used safely and securely wherever it's needed. We're creating the very best ideas that can most easily be put into action to help our clients improve the quality of care and lower costs for millions. This is where the best and the brightest work together to make positive change a reality. This is the place to do YOUR LIFE'S BEST WORK.

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.

A Fortune 6 company, we're focused on helping people live healthier lives while making the health system work better for everyone. Here, we seek to empower people with the information, guidance and tools to make personal health choices. We work harder and we aim higher. We expect more from ourselves and each other. And, at the end of the day, we’re doing a lot of good for more than 142 million people worldwide.