Collections Representative

About the Role

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.

Key Responsibilities

• Review outstanding insurance balances to identify and resolve issues preventing finalization of claim payment, including coordinating with payers, patients and clients when appropriate.
• Analyze and trend data, recommending solutions to improve first pass denial rates and reduce age of overall AR.
• Ensure all workflow items are completed within the set turn-around-time within quality expectations.
• Analyze EOBs and denials at a claim level, identifying trends impacting dollar and #'s, leading to process improvements.
• Perform other duties as assigned.

Requirements & Tech Stack

• Graduate (10+2+3).
• 18+ months and above experience in healthcare accounts receivable (Denial Management).
• 1+ Years of experience as Hospital Billing.
• Solid knowledge of medical insurance (HMO, PPO, Medicare, Medicaid, Private Payers).
• In-depth working knowledge of the various applications associated with the workflows.
• Solid knowledge and use of American English language skills with neutral accent.
• Functional knowledge of HIPAA rules and regulations and experience related to privacy laws, access and release of information.
• Proficient in MS Office software; particularly Excel and Outlook.

Qualifications

• Proven ability to communicate effectively with all internal and external clients.
• Proven ability to use good judgment and critical thinking skills; ability to identify and resolve problems.
• Proven efficient and accurate keyboard/typing skills.
• Proven solid work ethic and a high level of professionalism with commitment to client/patient satisfaction.