Billing Representative - Providence, RI - Full-time / Part-time

Position Description:

Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.

GENERAL SUMMARY/ OVERVIEW STATEMENT: Responsible for daily management of third party accounts receivable process and follow-up. Will maintain department standards on quantity and quality of accounts worked daily, accuracy of detail, documentation of work done, this includes daily screening and correcting of claims for accuracy as determined by department policies and procedures. Follow-up on original and pending claims. The employee is expected to call the insurance company, document the findings and gather and send the necessary documentation to process the claims. Resolve claims appeals. Once a claim is denied and an appeal is appropriate, appeals are to be done on timely basis in order to avoid the filing limit. The employee must be knowledgeable regarding what can be appealed and what is not. This includes gathering the information necessary to process the appeal accurately, including but not limited to, the review of payer guidelines, payer EOBs, physician documentation, authorization and eligibility verification, working with the client representative for a prospective charge correction, as well as accessing all systems available to research information to appeal the denial. The employee must have a clear understanding of the entire appeals process from start to finish and also be able to work effectively with the Billing Manager. Ad hoc projects as needed. Each employee must possess good interpersonal skills and demonstrate team work. Each employee must possess excellent organizational skills. The work area is expected to be neat and clean at all times. Each employee is expected to adhere to the rules and regulations of Optum. Each employee must demonstrate initiative, independence, and a willingness to learn new tasks. Candidate must also be able to work with minimal direction. Each employee must be able to work as a team and collaborate and contribute to solving problems.

WORKING CONDITIONS:Pleasant but busy office environment
This function is responsible for medical and ancillary product premium billing. 

Positions in this function interact with customers gathering support data to ensure invoice accuracy and also work through specific billing discrepancies. Provide input to policies, systems, methods, and procedures for the effective management and control of the premium billing function. Educate customers regarding the availability of receiving invoices and remitting payments through online applications. Monitor outstanding balances and take appropriate actions to ensure clients pay as billed. Manage the preparation of invoices and complete reconciliation of billing with accounts receivables. May also include quality assurance and audit of billing activities. 

Note: Positions mainly responsible for more general A/R activities which do not include medical and ancillary premium billing activities can be found in the Accounts Receivable function in the Finance job family.

Requirements:

• An education level of at least a high school diploma or GED required
• 1+ year of proven work experience 
• Intermediate
  proficiency with Windows PC applications, Microsoft Word and Excel,
  which includes the ability to learn new and complex computer system
  applications
• Authorization to work in the United States
• Available to work 40 hours per week any set schedule within the operating hours of the site Monday-Friday 7am-6pm

Assets:

• Completion of Medical Billing Certification preferred
• 3+ years of experience in a professional billing environment preferred
• Knowledge of Third Party Billing, CareTracker Product Knowledge preferred

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

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.

Diversity
creates a healthier atmosphere: All qualified applicants will receive
consideration for employment without regard to race, color, religion,
sex, national origin, protected veteran status, or disability status.

UnitedHealth
Group is a drug-free workplace. Candidates are required to pass a drug
test before beginning employment. In addition, employees in certain
positions are subject to random drug testing.