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Billing Representative - West Hills, CA

Company: UnitedHealth Group
Location: Arcadia
Posted on: March 15, 2020

Job Description:

Position Description

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.SM

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.

Taking care of business at UnitedHealth Group translates to more meaning and impact as you help improve the lives of millions. Join us. Learn more about how you can start doing your life's best work.SM

Primary Responsibilities:

  • Educate external customers / payers on payment options, billing information (e.g., where to send payment; when invoices are due; information contained on invoices), and / or services (e.g., eService; Invoice Inquiry), as appropriate
  • Inform customers / payers of billing problem / issue findings and resolution as appropriate - Contact external customers / payers to keep them informed of outstanding balances and required payment, as appropriate
  • Conduct training (e.g., on - line demonstration; ULearn; knowledge base; invoice inquiry) with internal and / or external customers / payers (e.g., new account managers; new sales staff; pricing teams) on how to access, review, and / or remit payment for invoices
  • Collaborate with internal partners (e.g., brokers, account managers) and / or external customers / payers to resolve customer issues - Provide requested reports and documents (e.g., invoices; payment histories; 5500 Forms Schedule A / C) to internal and / or external customers / payers (e.g., brokers; account managers)
  • Create and / or distribute documentation to inform internal and / or external customers / payers of new processes, procedures, or general changes to billing operations
  • Input information and / or determine appropriate medical codes from relevant resources (e.g., EMR; physician documentation) in order to generate claims for payment
  • Ensure accurate processing and completion of denied claims
  • Receive billing issues / information (e.g., enrollment; contract language; pricing; explanation of medical benefits) and gather relevant data to resolve
  • Seek assistance from internal partners (e.g., Sales; Plan Changes; Contract Installation; Underwriting; Clinics; Contracting; Credentialing) and / or external stakeholders (e.g., individual customers / payers; brokers) to resolve billing issues
  • Analyze relevant information to determine potential reasons for billing discrepancies
  • Ensure / verify source data is valid for billing and that it will be submitted to correct payer
  • Reconcile discrepancies identified within customer invoices / billing and reports
  • Demonstrate understanding of business partners' operations in order to identify appropriate resources for support and information
  • Generate and / or distribute reports and documentation (e.g., billing statements) to external customers / payers to inform them of premium balances
  • Perform queries on relevant systems (e.g., PeopleSoft; Access; Great Plains; CareTracker; Platinum; Micro Strategies; eCW) to gather data needed to analyze billing discrepancies and issues
  • Review / resolve claim edits prior to submission

    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 higher)
    • Proficient in Microsoft Excel (lookups, pivot tables, create, sort, and edit data in spreadsheets) and Microsoft Outlook (email and calendar management)
    • Ability to work Monday - Friday from 7am - 3:30pm with some flexibility in the schedule
    • Data Entry or 10 Key experience

      Preferred Qualifications:
      • Bachelor's Degree (or higher)
      • Previous knowledge or experience SQL
      • Medical terminology acumen
      • Previous work experience requiring exceptional data entry proficiency and accuracy
      • 1+ years of customer service experience
      • Previous experience with medical claims / billing processing

        Soft Skills:
        • Previous work experience in a fast paced environment requiring strong multi - tasking and problem solving skills

          Careers with OptumInsight. Information and technology have amazing power to transform the Healthcare industry and improve people's lives. This is where it's happening. This is where you'll help solve the problems that have never been solved. We're freeing information so it can be used safely and securely wherever it's needed. We're creating the very best ideas that can most easily be put into action to help our clients improve the quality of care and lower costs for millions. This is where the best and the brightest work together to make positive change a reality. This is the place to do your life's best work.SM

          Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

          UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

          Keywords: Billing Representative, Billing, California, West Hills

Keywords: UnitedHealth Group, Arcadia , Billing Representative - West Hills, CA, Other , Arcadia, California

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