Billing Representative - National Remote

You'll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.*

UMR, UnitedHealthcare's third-party administrator (TPA) solution, is the nation's largest TPA. When you work with UMR , what you do matters. It's that simple . . . and it's that rewarding.

In providing consumer - oriented health benefit plans to millions of people; our goal is to create higher quality care, lower costs and greater access to health care. Join us and you will be empowered to achieve new levels of excellence and make a profound and personal impact as you contribute to new innovations in a vital and complex system. Opportunities are endless for your career development and advancement within UMR due to our record-breaking growth.

Regardless of your role at UMR , the support you feel all around you will enable you to do what you do with energy, quality, and confidence. So, take the first step in what is sure to be a fast - paced and highly diversified career.

The medical billing and collection specialist is responsible for ensuring accurate billing, timely submission of electronic and/or paper claims, monitoring claim status, researching rejections and denials, documenting related account activities, posting adjustments and collections of Medicare, Medicaid, Medicaid Managed Care, and commercial insurance payers. The medical billing and collection specialist must possess critical thinking skills and understanding of Medicare, Medicaid eligibility requirements as well as commercial insurance payer payment methods to correctly record contractual adjustments base on payer contracts or government regulations. In addition, the medical billing and collection specialist must demonstrate proficiency with billing system to ensure all functionality is utilized for the utmost efficient processing of claims

Under the general direction of the Revenue Cycle Management Supervisor this position is responsible for the medical billing and collection specialist is responsible for ensuring accurate billing, timely submission of electronic and/or paper claims, monitoring claim status, researching rejections and denials, documenting related account activities, posting adjustments and collections of Medicare, Medicaid, Medicaid Managed Care, and commercial insurance payers. The medical billing and collection specialist must possess critical thinking skills and understanding of Medicare, Medicaid eligibility requirements as well as commercial insurance payer payment methods to correctly record contractual adjustments base on payer contracts or government regulations. In addition, the medical billing and collection specialist must demonstrate proficiency with billing system to ensure all functionality is utilized for the utmost efficient processing of claims

This position is full time Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7am-3:30pm Pacific Standard Time.

_*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy._

Primary Responsibilities:

• Responsible for charge and payment entry within Electronic Health Record. Coordinates and clarifies with providers, when necessary, on information that seems incomplete or is lacking for proper account/ claim adjudication

• Responsible for correcting, completing, and processing claims for all payer codes

• Analyze and interpret that claim are accurately sent to insurance companies

• Perform follow up with Medicare, Medicaid, Medicaid Managed Care, and Commercial insurance companies on unpaid insurance accounts identified through aging reports

• Process appeals online or via paper submission

• Assist in reconciling deposit and patient collections

• Assist with billing audit related information

• Process refund requests

• Communicate with billing and credentialing coordinator to identify and resolve audit review issues

• Process billing calls and questions from patients and third - party carriers

• Answer/respond to correspondence related to patient accounts. Is available to answer billing and changes related inquiries by patients, staffs, Managed Care Organization

• Communicate daily with internal and external customers via phone calls and written communications

• Identify trends, and carrier issues relating to billing and reimbursements. Report findings to Team Lead and/or Supervisor

• Research, record findings, and communicates effectively with Manager to achieve optimum performance

• Pursue and participate in education to remain current with changes in the Healthcare industry

• Maintain patient confidence and protects medical office operations by keeping patient information confidential

• Contribute to team effort by accomplishing related results as needed

• Promote effective working relations and work effectively as part of a team to facilitate the department's ability to meet its goals and objectives

• Demonstrate respect and regard for the dignity of all patients, families, visitors, and fellow employees to insure a professional, responsible and courteous environment

• Perform other duties as assigned to support Excel's Mission, Vision, and Values

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 or GED

• Must be 18 years old or older

• 2+ years of experience working in the medical field such as billing, coding or medical insurance.

• 2+ years of experience working with Medicare / Medicaid / Managed Care claims

• Familiarity with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications.

• Microsoft Word, Microsoft Excel and Microsoft Outlook

• Ability to work Monday- Friday - 7:00am-3:30pm Pacific Standard Time

Preferred Qualifications:

• Bilingual fluency in English and any of the following: Spanish, Vietnamese, Chinese, Tagalog

• Previous experience in a medical office setting with Electronic Medical Records

• Knowledge of healthcare regulations and guidelines including: CMS, DMHC, and/or DHCS guidelines

• Knowledge of Correct Coding Initiative, HCFA-1500 and UB-92 claim forms and CPT Coding

• Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume

• Understanding of medical terminology and insurance laws/guidelines

Telecommuting Requirements:

• Ability to keep all company sensitive documents secure (if applicable)

• Required to have a dedicated work area established that is separated from other living areas and provides information privacy.

• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.

Soft Skills:

• Ability to apply common sense understanding to carry out instructions furnished in written, oral, and diagram form

• Ability to deal with problems involving several concrete variables in standardized situations

• Detail oriented

• Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources

• Ability to solve problems through systematic analysis of processes with sound judgment

• Accountability for one's own actions

• Convey care when answering phone calls and assisting customers

• The ability to effectively interact with both external and internal customers in difficult situations

• Ability to make sound decisions

• Maintain confidentially when handling sensitive material

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Washington or Rhode Island Residents Only: The hourly range for this is $16.54 - $32.55 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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.

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 .

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