UnitedHealth Group Technical Denials Representative - Phoenix, AZ or Sacramento, CA in Phoenix, Arizona
Position Description: Healthcare isn’t just changing. It’s growing more complex every day.
ICD-10 Coding replaces ICD-9.
Affordable Care adds new challenges and financial constraints.
Where does it all lead? Hospitals and Healthcare organizations continue to adapt, and we are vital part of their evolution.
And that’s what fueled these exciting new opportunities. Who are we? Optum360. We’re a dynamic new partnership formed by Dignity Health and Optum to combine our unique expertise.
As part of the growing family of UnitedHealth Group, we’ll leverage our compassion, our talent, our resources and experience to bring financial clarity and a full suite of Revenue Management services to Healthcare Providers, nationwide. If you’re looking for a better place to use your passion, your ideas and your desire to drive change, this is the place to be. It’s an opportunity to do your life’s best work.The Technical Denials Representative position is responsible for determining the reason for payment delinquency, negotiate and advise on collection of denied claims and take appropriate action to recover denied payments.
Handling of unresolved inquiries / issues, and responsible for developing, implementing, maintaining and managing organization policies on denial appeal management.
The representative will manage their assigned work to ensure Medicaid appeal / filing deadlines are met and achieve optimal payment for services rendered.
May work with outside legal counsel and / or outside agencies in more complex collection cases.Primary Responsibilities: Monitors denial work queues and reports in accordance with policies and procedures and supervisor guidance Prioritizes and reviews cases denied by Medicaid payers Determines actions required for appeals within contractual timeframes Maintains required levels of productivity and quality Works with other departments and resources to resolve issues, as needed Required Qualifications:High School Diploma or GED 3+ years of experience working in a hospital billing and collections office 3+ years of working knowledge of medical terminology and billing / collection practices 3+ years of experience and proficiency with timely and successful appeals to third party payers 3+ years of experience utilizing Microsoft Office Suite including Excel with the ability to create basic spreadsheets and enter data in a professional office setting 1+ years of experience reading and interpreting insurance explanation of benefits (EOBs)Ability to work any shift between the hours of 6:00 am - 5:00 pm Monday through Friday, 40 hours per weekPreferred Qualifications: Knowledge of payer edits, rejections, rules, and how to appropriately respond to each Knowledge of determining root cause of rejections / denialsSoft Skills: Strong written, communication, presentation and organizational skillsThere are several steps in our hiring process it's a thorough process because we want to ensure the best job and culture fit for you and for us.
In today's ultra-competitive job market, the importance of putting your best foot forward is more important than ever.
And you can start by completing all required sections of your application.
profile, history, certifications and application/job questions).
Once you submit your resume, you’ll receive an email with next steps.
This may include a link for an on-line pre-screening test that we ask you to complete as part of our selection process.
You may also be asked to complete a digital video interview, but we will offer full instructions and tips to help you.
After you have completed all of these steps, you can check on the status of your application at any time, but you will also be notified via e-mail.Careers with OptumInsight. Information and technology have amazing power to transform the Healthcare industry and improve people's lives.
This is where it's happening.
This is where you'll help solve the problems that have never been solved.
We're freeing information so it can be used safely and securely wherever it's needed.
We're creating the very best ideas that can most easily be put into action to help our clients improve the quality of care and lower costs for millions.
This is where the best and the brightest work together to make positive change a reality.
This is the place to do your life’s best work.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. Keywords: Technical denials representative, hospital billing, collections representative, appeals, customer service representative, optum360 7f30ee4c-dcfe-4f0e-84a9-75975b635baa
Technical Denials Representative - Phoenix, AZ or Sacramento, CA AZ-Phoenix 716543