Managed Care Sr. Patient Account Representative - Rancho Cordova, CA

Health
care isn't just changing.  It's growing more complex every day.  ICD10
replaces ICD9.  Affordable Care adds new challenges and financial
constraints.  Where does it all lead?   Hospitals and health care
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 health care 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. 

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.

This position is responsible for the clerical duties relating
to the timely follow up and reconciliation of accounts billed to Commercial,
Managed Care insurance companies and some Government programs. Typical duties
include; review accounts receivable aging report; trace and appeal unpaid
and/or erroneously paid or denied accounts; work selected return billings for
reprocessing; verify and adjust accounts according to payer or program
specifications; appeals, refunds and performs other related duties as assigned.

Primary
Responsibilities:

• Contact customers to determine
  reason for payment delinquency

• Negotiate and advise on collection
  of overdue claims and take appropriate action to recover overdue payments

• Handle unresolved inquiries/issues

• Responsible for developing,
  implementing, maintaining and managing organization policies on collection
  practices

• May work with outside legal counsel
  and/or outside agencies in more complex collection cases

• Some work is completed without
  established procedures.

• Basic tasks are completed without
  review by others.

• As
  a Senior Patient Account Representative you will need knowledge of: 

• Hospital
  or patient accounting department functions, operations and
  procedures 

• Medical
  terminology, procedure and diagnosis coding sufficient to assess accuracy
  of patient accounts 

• Covered
  benefits, billing requirements and procedures for third party payers
  and/or Government Programs

• Data
  elements for UB04 and/or State of California Medi-cal Program

• Operation
  of on-line computerized patient accounting systems and/or electronic
  billing systems

• Accounting
  practices and procedures common to accounts receivable

• General
  clerical office practices and procedures 

• Medical
  terminology

• HCPCS/CPT
  and ICD9 /ICD10 Coding

• Hospital
  and patient accounting department functions

• Insurance
  policies and their benefits

• Data
  processing input devices

• Accounts
  receivable practices and procedures

• General
  clerical office practices  

• Knowledge
  of payer contracts