Medicare Reimbursement Specialist
UnitedHealth Group - Atlanta, GA

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Position Description:
When you are in the business of health care, you're in the business of people. At UnitedHealth Group we want every customer experience to be distinctly personal. The challenge is complex. When people call us for help, their focus is on getting the best care possible. We help them understand their benefits and their options. This part of their lives matters a lot to them and it matters just as much to us. Our customer service teams have a serious responsibility to make every contact informative, productive, positive, and memorable for what it says about how much we care.

This function is responsible for insurance premium collections. Positions in this function contact customers to determine reason for payment delinquency. Negotiate and advise on collection of overdue bills and take appropriate action to recover overdue payments. Handles 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.

Primary Responsibilities:
Some work is completed without established procedures.

Basic tasks are completed without review by others.

Supervision/guidance is required for higher level tasks.

Contact customers to determine reason for payment delinquency

Negotiate and advise on collection of overdue bills 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

Moderate work experience within own function

Requirements

Requirements:
High school diploma/GED

3+ years Hospital billing/collections experience required

3+ years patient Accounting experience with a focus on Medicare Part A and Part B

Previous experience with UB04 and CMS1500
Working knowledge of Medicare CWF/HIQA, and denial resolution

Knowledge of ICD-9 coding

Working knowledge of Florida Shared System (FSS)

Recent hospital follow up experience

Must be able to resolve Medicare Denials and read and interpret EOBs (Explanation of benefits)

In-depth understanding of cross-over claims

Assets:
Proficiency with Client Payment systems (i.e. E-Premise, Emdeon, Star, Meditech, and Siemens)

Experience with DDE (Direct Data Entry) systems

CPAR, CPAT, or CPC/H certification a plus

OptumInsight is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.

OptumInsight is one of the largest and fastest growing health information companies. We specialize in improving the performance of the health system by providing analytics, technology and consulting services that enable better decisions and results. We integrate workflow solutions that deliver data in real-time, and create actionable insights - processing health information that relates directly to and affects one in four patients in the U.S, one in every three Medicaid dollars and one in every five emergency room visits. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.

What can YOU do with the right information? At OptumInsight, the possibilities and the impact are limitless. No matter what your role is at OptumInsight, you'll be empowered to ask more questions, develop better solutions and help make the health care system greater than ever. It's always fresh. It's always exciting. And it's never been more important.

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.

UnitedHealth Group - 10 months ago - save job - block
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