Collections Representative

Responsibilities

• Review outstanding insurance balances to identify and resolve issues preventing finalization of claim payments
• Coordinate with payers, patients, and clients to resolve billing discrepancies
• Analyze and trend denial data to recommend solutions that improve first-pass denial rates and reduce AR age
• Analyze EOBs and denials at a claim level to identify trends impacting revenue
• Ensure all workflow items are completed within set turnaround times and quality expectations
• Execute standard operating procedures (SOPs) and communicate trends or concerns to leadership

Requirements

• Graduate degree
• 1.5+ years of experience in healthcare accounts receivable and denial management
• Functional knowledge of HIPAA rules, regulations, and privacy laws
• Solid knowledge of medical insurance types including HMO, PPO, Medicare, Medicaid, and Private Payers
• Proficiency in MS Office software, specifically Excel and Outlook
• Strong communication, critical thinking, and problem-solving skills
• Proven ability to maintain professionalism and a commitment to client/patient satisfaction

Benefits

• Physical: Health plans and other coverage to support wellness for you and your loved ones
• Emotional: Education, tools, and resources to help manage stress and build resilience
• Financial: Benefits to help you plan for the future, including retirement options
• Life: Resources and support designed to help you focus on what matters most

About the Company

Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. We connect people with the care, pharmacy benefits, data, and resources they need to feel their best.