Collections Representative (MarinHealth) - San Rafael, CA
Company: UnitedHealth Group
Location: San Rafael
Posted on: September 20, 2023
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Job Description:
$1,000 Sign On Bonus For External Candidates
If you are located in San Rafael, CA, you will have the flexibility
to work from home and the office in this hybrid role* as you take
on some tough challenges.
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. Here, you will find a
culture guided by diversity and inclusion, talented peers,
comprehensive benefits and career development opportunities. Come
make an impact on the communities we serve as you help us advance
health equity on a global scale. Join us to start Caring.
Connecting. Growing together.
This position is full-time (40 hours/week) Monday - Friday.
Employees are required to have flexibility to work any of our
8-hour shift schedules during our normal business hours between
5:30am - 8:30am PST. It may be necessary, given the business need,
to work occasional overtime. Our office is located at -3950 Civic
Center Drive San Rafael, CA 94903.
We offer 90 days of paid training. -
Our office is located at 3950 Civic Center Drive San Rafael, CA.
-Employees will be required to work some days onsite and some days
from home
*All Telecommuters will be required to adhere to UnitedHealth
Group's Telecommuter Policy.
Primary Responsibilities:
Correction of claims, based on personal knowledge and system
identified errors to assure claims are submitted accurately
Performs timely follow up with the payer to determine status of
claim and processing of the payment
Utilizing personal skills developed, performs timely follow up
through phone calls, investigative work, re-bills and on-line
applications to assure accounts are resolved in a timely and
efficient manner
Responsible for maintaining current and ongoing knowledge of State
and Federal guidelines as they pertain to the accurate resolution
of accounts
Responsible for reviewing the Expected Payment variance reports for
incorrect payments on accounts
Responsible for all accounts assigned to assure the hospital
receives accurate and timely payment
Ability to manage work flows to assure accounts are not lost due to
timely billing and other preventable errors
Identified underpayments are reviewed to determine the reasons and
appropriate actions taken to correct the discrepancies. - These
actions may include, but not be limited to phone calls, appeal
letters, working with the attending MD and HIM
Identifies specific problems or trends, develops appropriate
tracking tools, and keeps Manager and Director informed
Responsible for handling all levels of questions and issues from
insurance companies, appropriate governmental agencies, patients,
and doctor's offices
Responsible for maintaining productivity within overall established
Business Office guidelines. - All variances in overall productivity
will be evaluated and corrective action developed with
Management
Researches and completes credit/charge corrections and
write-offs
Handles all written correspondence addressed to their area
Utilizes the Hospital Information system to research accounts in a
timely and effective manner
Maintains copies of appeals and correspondence either at
workstation, cash folders or personal filing systems. - Copies must
be maintained in alphabetic order by year of service
Correspondence could include: arbitration appeals for Managed Care,
1st report of injuries, follow up letters specific to claims and
carriers, ABN's, and TAR's
Participates actively in the achievement of organizational and
departmental goals
Attends and participates in in-services and staff meetings. -
Maintains standards of the organization and department
Abides by hospital policies on attire, work habits and
relationships. - Observes confidentiality and decorum in
conversation and behavior
Assists in the orientation of new employees
Other duties as assigned
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)
2 + years of medical office or hospital business office experience
including billing/account collections for non-Government (private)
health insurance, Other Government, Medicare and Medi- (excluding
dental experience)
1+ years of PFS (Patient Financial Services) experience (excluding
dental experience)
Proficiency with Windows PC applications, which includes the
ability to navigate multiple programs and learn new and complex
computer system applications
Ability to work/train onsite until productivity goals are met
Ability to work a 40-hour schedule within the operating hours of
the site
Ability to work 8 hours shift starting between 5:30am - 8:30am
PST
Preferred Qualifications:
Working knowledge of all areas related to the resolution of
non-Government and/or Government accounts and the regulatory
requirements for each payer
Experience in Medicare, Medi-Cal, HMO, PPO, Work Comp, County or
Champus etc.,
Telecommuting Requirements:
Reside within commutable distance to the office in -San Rafael,
CA
Required to have a dedicated work area established that is
separated from other living areas and provides information
privacy
Ability to keep all company sensitive documents secure (if
applicable)
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 work tactfully and professionally with patients, family
members, hospital staff, medical staff, outside payers and
vendors
Ability to problem solve, multitask efficiently, organize, and
prioritize multiple tasks with minimum supervision
Run outstanding balance reports and research, collect or re-bill
when appropriate
Strong verbal and written communication skills are critical when
working with payers (May need to initiate written appeals for
contract discrepancies and underpayments)
Understanding of the overall diversity of our patient population
and treating everyone with respect and courtesy
Comprehension of commercial payer reimbursement to determine
contract compliance and payment performance
Has thorough knowledge of Coordination of Benefits relative to
primary versus secondary payers according to contractual and
governmental guidelines
Understanding of the overall diversity of our patient population
and treating everyone with respect and courtesy
California Residents Only: The salary range for California
residents is $16.00 - $31.44.Pay is based on several factors
including but not limited to education, work experience,
certifications, etc. 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
**PLEASE NOTE** The sign on bonus is only available to external
candidates. Candidates who are currently working for a UnitedHealth
Group, UnitedHealthcare or related entity in a full time, part
time, or per diem basis ("Internal Candidates") are not eligible to
receive a sign on bonus.
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.
#RPO #YELLOW
Keywords: UnitedHealth Group, San Rafael , Collections Representative (MarinHealth) - San Rafael, CA, Accounting, Auditing , San Rafael, California
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