Medi-Cal Hospital Collections Representative - National Remote

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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, Monday - Friday. Employees are required to work during our normal business hours of 8:00am - 4:30pm PST (with flexibility to adjust for team meetings). It may be necessary, given the business need, to work occasional overtime.

We offer 4 weeks of on-the-job training. The hours of training will be during our normal business hours.

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

Primary Responsibilities

• Billing according to Medi-Cal/Managed Care Plans (California) guidelines
• Follow up directly with Medi-Cal/Managed Care regarding outstanding claims
• Filing appeals directly with Medi-Cal/Managed Care
• Perform research on various computer systems and document customer information regarding status, payment expectations, and other relevant information
• Use mail, email, and phones to contact customers to discuss, negotiate payment and resolve outstanding medical bill accounts and balances
• Obtain agreement on potential balance payoff and/or payment terms within stated level of authority and guideline limits
• Prepare and submits reports to internal management on status of outstanding medical bills and proposed/planned payment settlement details
• Record correspondence information (e.g., dates; action taken) within relevant collection systems
• Strong working knowledge of all areas related to the resolution of Medi-Cal/Managed Care accounts and the regulatory requirements. Overall skills would be specific to the type of accounts handled
• Knowledge of Coordination of Benefits relative to primary versus secondary payers according to contractual and governmental guidelines
  
  

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

• Must be 18 years of age OR older
• 1+ years of Hospital Medical Collections experience
• 6+ months of working experience with Medi-Cal / Managed Care Plans (California) guidelines
• Experience with Medi-Cal / Managed Care claims follow-up
• Experience contacting insurance companies to verify the status of unpaid claims and ensure timely payment
• Experience using a UB04 form
• Computer skills, including working knowledge of Microsoft Windows and navigation, mouse, and keyboard skills
• Ability to work Monday - Friday, during our normal business hours of 8:00am - 4:30pm PST (with flexibility to adjust for team meetings). It may be necessary, given the business need, to work occasional overtime
  
  

Preferred Qualifications

• Computer knowledge of EPIC
  
  

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
• All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
  
  

The hourly range for this role is $16.88 to $33.22 per hour based on full-time employment. 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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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