Provider Recovery Specialist - Franklin, TN - Full-time / Part-time

Position Description: 

Energize your career with one of Healthcare's fastest growing companies.  
 
You dream of a great career with a great company – where you can make an impact and help people.  We dream of giving you the opportunity to do just this.  And with the incredible growth of our business, it's a dream that definitely can come true. Already one of the world's leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives.  We live for the opportunity to make a difference and right now, we are living it up.

This
opportunity is with one of our most exciting business areas: Optum –a growing
part of our family of companies that make UnitedHealth Group a Fortune 17 leader.

 

Optum helps nearly 60
million Americans live their lives to the fullest by educating them about their
symptoms, conditions and treatments; helping them to navigate the system,
finance their healthcare needs and stay on track with their health goals. No
other business touches so many lives in such a positive way. And we do it all
with every action focused on our shared values of Integrity, Compassion,
Relationships, Innovation & Performance.

 
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.

The Provider Recovery Specialist is responsible for incoming and outgoing calls in regards to Provider overpayments and refunds. The representative is responsible for managing inventory, working within specific timeframes in a position where multitasking is key in order to meet deadlines.

Positions in this function are responsible for working in a fast-paced call production environment, using collection skills and persuasion techniques to help meet financial targets, and working with recovering and resolving accounts for health plans, commercial customers, and government entities. Work in the position includes inbound and outbound calling, working within multiple systems and claim platforms, and balancing production, financial, and quality goals. 
  
Primary Responsibilities:

• Reviewing claim payments, offsets, and appeals in regards to overpaid claims for health plans, commercial customers, and government entities
• Analyze, identify trends, and provide reports as necessary
• Ensure adherence to state and federal compliance policies, reimbursement policies, and contract compliance
• Perform other duties as assigned
• Working independently and self-sufficiently
• Working as a mentor to others within the team
• Heavy emphasis on teamwork and communication

Requirements:

• High School Diploma or GED
• 1+ years of customer service experience; i.e. analyzing and solving customer problems
• Intermediate level of proficiency with MS Excel; i.e. creating spreadsheets, sorting, filtering, etc.
• Must be available during hours of operation, 7:00am to 7:00pm Monday to Friday

Assets: 

• Experience in medical claims and/or adjustments
• Experience within a Collector role; i.e. someone who has previously or is currently working in 3rd party or debt collector, delinquent accounts and collections from business and consumers
• 1+ years of Call Center experience
• 1+ years of experience of working in healthcare (i.e. working in an insurance setting, in a provider's office, billing office, doctor's office, etc) or with medical insurance (i.e. dealing with insurance from a billing and/or health plan standpoint)
• Customer service experience in a healthcare and call center environment

At Optum, you will perform within an innovative culture that's focused on transformational change in the Healthcare system. You will leverage your skills across a diverse and multifaceted business. And you will make contributions that will have an impact that's greater than you've ever imagined.