This position is Onsite. Our office is located at 2750 Front St, Cuyahoga Falls, OH.
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
This position has management and operational responsibilities for revenue cycle activities, including maintaining days in AR standards, financial policy development, denial management, work flow, and customer service functions for Premiere Medical Resources, under the supervision of the Director, Revenue Cycle Management.
This position is full time, Monday - Friday. Employees are required to have flexibility to work any of our shift schedules during our normal business hours of 8:00 am - 5:00 pm. It may be necessary, given the business need, to work occasional overtime.
This will be on the job training and the hours during training will be aligned to your schedule.
Primary Responsibilities:
- Manages, trains, coaches, and develops staff in all areas of responsibility to ensure efficient revenue cycle operations
- Manages revenue cycle functions including A/R of insurance claims and other sources of reimbursement as applicable
- Ensures compliance with Medicare/Medicaid billing guidelines as well as specific policies of commercial carriers. Ensures compliance with HIPPA and other regulatory requirements for responsible areas
- Prepares, organizes, audits/corrects and submits electronic and paper claims to government and commercial insurance carriers as assigned
- Assigns claim denials and appeals to AR Representatives as appropriate by carrier, and contracts. Monitors workflow and appeal timeframes
- Reviews escalated denials and appeals to facilitate processing; collaborates with Managed Care Department as needed
- Ensures all revenue cycle activities are performed in the most efficient, timely manner and most appropriate setting. Ensures excellent customer service is upheld
The above stated duties are intended to outline those functions typically performed by the incumbent in this position. This description of duties is not intended to be all-inclusive nor to limit the discretionary authority of supervisors to assign additional tasks of a similar nature or level of responsibility
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 equivalent years of work experience
- Must be 18+ years of age OR older
- 2+ years of related experience, including billing in a physician office OR billing company environment
- Experience with computers and Windows PC applications, which includes the ability to learn new and complex computer system applications
- Ability to work full time, Monday - Friday. Employees are required to have flexibility to work any of our shift schedules during our normal business hours of 8:00 am - 5:00 pm. It may be necessary, given the business need, to work occasional overtime.
Preferred Qualifications:
- CMIS certification
- Experience in a supervisory OR leadership role
Soft Skills:
- Strong problem solving skills
- Service and results oriented with exceptional leadership, communication, and organizational skills
- Ability to establish and maintain effective relationships with patients, physicians, insurance companies and other customers is essential
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
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