Associate Billing Representative - Phoenix, AZ, Sacramento, CA, Atlanta, GA, Nashville, TN

Healthcare 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 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 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.

Primary Responsibilities:

• Performs billing functions relevant to the Patient Financial Services area in a manner that meets or exceeds key performance criteria.
• Maintains thorough and detailed knowledge of insurance and self- pay billing and follow up guidelines and regulations for third-party payers. Exhibits an understanding of state and federal billing and follow up regulations as it relates to Medicare, Medicaid, and Managed Care and Commercial Insurance companies.
• Demonstrates knowledge of standard bill forms and filing requirements. Exhibits an understanding of electronic claims editing and submission capabilities including Medicare and NEIC on-line claims processing and query system.
• Exhibits an understanding of CPT, HCPCS and ICD-9 coding regulations and guidelines.
• Ability to recognize and identify payer trends and communicate effectively to PFS Leadership Team.
• Functions as a subject matter expert in assisting Customer Service and Collection Team Members as well as other payer team members.
• Functions effectively within a team and participates and contributes constructively to produce results in a cooperative effort.
• Continually seeks to understand and act upon customer needs, concerns, and priorities. Meets customer expectations and requirements, and gains customer trust and respect.
• Demonstrates ongoing enthusiasm and commitment to the work assigned.
• Works with Supervisor to receive feedback on performance and create a personal development plan. 

• High School Diploma or GED
• 1+ years experience performing billing and/ or follow-up functions within a multi-facility hospital environment
• 1+ years experience and excellent working knowledge of third-party billing regulations and requirements including claims editing and submission processes
• 1+ years experience working with inpatient and outpatient billing requirements of UB-04 and 1500
• Demonstrated success working in a team environment focused on meeting organization goals and objectives 
  

• Demonstrated working knowledge of current patient accounting and claims editing applications in a tertiary hospital environment preferred
• Some college coursework in business administration or accounting preferred