Collections Representative - AR Calling - RCM Denial Management
Operations Maintenance & Support
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Job Description
- 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
- Accounts Receivable Specialist that has an "understanding" of the whole accounting cycle / claim life cycle
- Ensure all workflow items are completed within the set turn-around-time within quality expectations
- Able to analyze EOBs and denials at a claim level in addition they should find trends impacting dollar and leading to process improvements
- Perform other duties as assigned
- Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so
- Functional knowledge of HIPAA rules and regulations and experience related to privacy laws, access and release of information
- Solid knowledge and use of the American English language skills with neutral accent
- Proficient in MS Office software; particularly Excel and Outlook
- 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 a commitment to client/patient satisfaction
Skills
HIPAAHealthcareDenial ManagementEnglishAccounts ReceivableAmerican EnglishPharmacyManagementOperationsIf a job posting appears fraudulent, asks for payment, contains misleading information, or violates our guidelines, please report it immediately. Our team will review it promptly, Jobaaj does not charge any fee from the applicants.
About Company
Optum, a leading health services and innovation company, offers a broad spectrum of opportunities for professionals seeking to advance their careers in the healthcare industry. With a focus on improving the healthcare system and helping people live healthier lives, Optum careers present a unique blend of technology, health services, and operational expertise. Optum's commitment to innovation and its global reach provide a dynamic platform for individuals pursuing an Optum career, enabling them to contribute to transforming healthcare through cutting-edge solutions and services.
At the heart of Optum's mission is a diverse and inclusive workforce dedicated to addressing complex health challenges. Optum careers offer paths in areas such as data analytics, technology development, consulting, pharmacy care services, and healthcare operations. Each Optum career path is designed to leverage the talents of its employees, fostering an environment of continuous learning and professional growth.
Optum's global presence means that Optum careers span a wide range of geographical locations, allowing professionals to work in diverse settings and cultures. This international footprint enriches the Optum career experience, providing a broader perspective on healthcare innovation and best practices worldwide.
For those interested in pursuing an Optum career, the company regularly posts job openings across various disciplines, emphasizing the importance of meaningful work that contributes to the broader goal of enhancing health outcomes. Optum careers are not just jobs; they are opportunities to make a significant impact in one of the most vital sectors of our society.
Optum also values the development of its employees, offering robust training programs, mentorship opportunities, and the chance to work on transformative projects. An Optum career means being at the forefront of healthcare, where one can genuinely make a difference in the lives of millions.
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