Job Description

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

This position is full-time (40 hours/week) Monday - Friday. Employees are required to work our normal business hours of 7:00am - 4:30pm Monday - Thursday and Friday from 7:00am - 11:00am. It may be necessary, given the business need, to work occasional overtime or weekends.

If you are located within 30 miles of Norristown, PA, you will have the flexibility to telecommute* as you take on some tough challenges. Training will be conducted virtually from your home.

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Primary Responsibilities:

* Analyze and apply denials to third party carriers in all media types
* Comply with departmental Business Rules and Standard Operating Procedures
* Focus efforts on decreasing the Accounts Receivable, increasing cash, and / or reducing bad debt
* Interpret explanation of benefits for appropriate follow up action
* Utilize automation tools to verify eligibility, claim status and / or to obtain better billing information
* Create work list through database and manipulate data to analyze for trends and resolve claims for adjudication
* Review and research denied claims by navigating multiple computer systems and platforms, in order to accurately capture data / information for processing
* Communicate and collaborate with members or providers to evaluate claims errors / issues, using clear, simple language to ensure understanding
* Conduct data entry and rework for adjudication of claims
* Work on various other projects as needed
* Meet the performance goals established for the position in the areas of: efficiency, accuracy, quality, patient and client satisfaction and attendance

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 customer service experience
* 1+ years of experience in A / R, Billing, and Customer Service, Insurance, or Healthcare
* Demonstrated ability using computers and Windows PC applications, which includes strong keyboard and navigation skills and ability to learn new computer programs
* Previous work experience requiring exceptional data entry proficiency and accuracy
* Medical terminology acumen
* Must be located within 30 miles of Norristown, PA
* Required to have a dedicated work area established that is separated from other living areas and provides information privacy
* Ability to keep all company sensitive documents secure (if applicable)
* Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
* If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

Preferred Qualifications:

* Associate's Degree (or higher)
* Certified medical coder or involved with medical coding
* Previous experience with medical claims processing

Soft Skills:

* Previous work experience in a fast-paced environment requiring strong multi - tasking and problem solving skills

UnitedHealth Group is an essential business. The health and safety of our team members is our highest priority, so we are taking a science driven approach to slowly welcome and transition some of our workforce back to the office with many safety protocols in place. We continue to monitor and assess before we confirm the return of each wave, paying specific attention to geography-specific trends. At this time, 90% of our non - clinical workforce transitioned to a work at home (remote) status. We have taken steps to ensure the safety of our 325,000 team members and their families, providing them with resources and support as they continue to serve the members, patients and customers who depend on us.

You can learn more about all we are doing to fight COVID-19 and support impacted communities at: https://www.unitedhealthgroup.com/newsroom/addressing-covid.html

Careers with Optum360. At Optum360, we're on the forefront of health care innovation. With health care costs and compliance pressures increasing every day, our employees are committed to making the financial side more efficient, transferable and sustainable for everyone. We're part of the Optum and UnitedHealth Group family of companies, making us part of a global effort to improve lives through better health care. In other words, it's a great time to be part of the Optum360 team. Take a closer look now and discover why a career here could be the start to doing your life's best work. SM

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.

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