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Collections Representative(US Health Care, RCM, AR/Denials , Hospital Billing)

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Optum

Jan 3

Applications are closed

  • Job
    Full-time
    Expert Level
  • Accounting & Tax
    Healthcare
  • Hyderabad, +1

Requirements

  • Should be a Graduate
  • 12+ months and above experience in healthcare accounts receivable required (Denial Management)
  • 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 the American English language skills with neutral accent
  • Ability to communicate effectively with all internal and external clients
  • Ability to use good judgment and critical thinking skills; ability to identify and resolve problems
  • Proficient in MS Office software; particularly Excel and Outlook
  • Efficient and accurate keyboard/typing skills
  • Solid work ethic and a high level of professionalism with a commitment to client/patient satisfaction
  • Functional knowledge of HIPAA rules and regulations and experience related to privacy laws, access and release of information

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
  • 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 #'s, 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

FAQs

What is the primary responsibility of an AR Associate at Optum?

The primary responsibility of an AR Associate is to handle the accounts receivable aspects of client-focused revenue cycle operations, which includes reviewing outstanding insurance balances, resolving claim payment issues, analyzing data to recommend improvements, and ensuring workflow items are completed within set turnaround times.

What qualifications are required for this position?

Candidates should be graduates with 12+ months of experience in healthcare accounts receivable, particularly in denial management, and possess solid knowledge of medical insurance (HMO, PPO, Medicare, Medicaid, Private Payers).

Is previous experience in healthcare accounts receivable necessary?

Yes, a minimum of 12 months of experience in healthcare accounts receivable, specifically in denial management, is required.

What software proficiency is needed for this role?

Proficiency in MS Office software, particularly Excel and Outlook, is required, along with efficient and accurate keyboard/typing skills.

What communication skills are necessary for this position?

Candidates must have solid knowledge and use of the American English language, with a neutral accent, and the ability to communicate effectively with all internal and external clients.

Are knowledge of HIPAA regulations and privacy laws important for this role?

Yes, functional knowledge of HIPAA rules and regulations, as well as experience related to privacy laws, access, and release of information, is essential.

What opportunities for career development does Optum offer?

Optum offers comprehensive benefits and various career development opportunities to support the professional growth of its employees.

What is the work culture like at Optum?

The work culture at Optum is guided by diversity and inclusion, fostering collaboration among talented peers while focusing on advancing health equity on a global scale.

Do employees have to comply with company policies and procedures?

Yes, employees are required to comply with the terms and conditions of the employment contract, company policies and procedures, and any directives that may arise due to changing business environments.

Is a solid work ethic important for this role?

Yes, a solid work ethic, high level of professionalism, and a commitment to client/patient satisfaction are essential qualities required for success in this position.

Science & Healthcare
Industry
10,001+
Employees

Mission & Purpose

Optum is a health services and technology company that provides a wide range of solutions to improve healthcare delivery and outcomes. They offer services in healthcare management, data analytics, pharmacy benefit management, and technology solutions to healthcare providers, payers, employers, and government agencies. Optum's ultimate mission is to improve the health system's efficiency and effectiveness, creating a healthier world for everyone. Their purpose lies in collaborating with healthcare partners to address complex challenges, such as improving care coordination, reducing healthcare costs, and enhancing patient experiences. By leveraging data-driven insights and innovative technology, Optum aims to empower healthcare professionals and organisations to deliver high-quality, patient-centered care and drive positive healthcare outcomes for individuals and communities worldwide.

Culture & Values

  • Integrity

    Honour commitments. Never compromise ethics.

  • Compassion

    Walk in the shoes of people we serve and those with whom we work.

  • Relationships

    Build trust through collaboration.

  • Innovation

    Invent the future, learn from the past.

  • Performance

    Demonstrate excellence in everything we do.

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