Job Description

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.

The A/R Billing Clerk position is responsible for validating patient’s insurance coverage, processing recurring rentals, claims coding, claims billing including price validation, assisting patient accounts with billing discrepancies, payment posting and working denials in CareTend management software. They are responsible for follow up with payers for more information or payment. Southwest Medical Pharmacy and HME processes an average 22,000 claims per month. This total includes an average 15,000 electronic claims and 5,000 paper claims each month. The A/R Billing Clerks are responsible for follow up on an average 4,000 claims per month. They process all of the credits and corrected billing for patients and insurances.

This position is full time Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8a:00 m – 4:30 pm. It may be necessary, given the business need, to work occasional overtime. Employees are required to work some days onsite and some days from home.

The first 4-6 weeks will be onsite for training and shadowing. Once training is complete, you will transition to a hybrid schedule, working onsite and remote from home.

If you are within commutable distance to the office at Las Vegas, NV, you will have the flexibility to work from home and the office in this hybrid role* as you take on some tough challenges.

Primary Responsibilities:

• Interact with customers gathering support data to ensure invoice accuracy and also work through specific billing discrepancies
• Provide input to policies, systems, methods, and procedures for the effective management and control of the premium billing function
• Educate customers regarding the availability of receiving invoices and remitting payments through online applications
• Monitor outstanding balances and take appropriate actions to ensure clients pay as billed
• Manage the preparation of invoices and complete reconciliation of billing with accounts receivables
• May also include quality assurance and audit of billing activities
• Resolve most questions and problems, and refers only the most complex issues to higher levels

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
• Must be 18 years of age OR older
• 2+ years of experience with accounts receivable in Multi-Specialty (ex. Adult Medicine, OBGYN, Pediatrics, Cardiology, Pain Management, Urgent Care)
• Ability to review and understand the explanation of benefits
• 2+ years of experience with claims processing or claims appeals/reconsiderations
• Medical terminology knowledge
• Basic computer skills (i.e., Microsoft office & Microsoft Excel proficiency)
• Experience with and understanding of ICD10 and CPT coding - including modifiers
• Ability to type at the speed of 45 WPM (words per minute)
• Ability to work onsite at 2716 Tenaya Way, Las Vegas, NV
• Ability to work any 8-hour shifts between 8:00 am - 4:30 pm from Monday - Friday including the flexibility to work occasional

Preferred Qualifications:

• 1+ years experience with medical insurance groups such as BCBS, Cigna, Aetna, and Health Plan of Nevada, UHC
• 1+ years with Medicare and / OR Medicaid billing experience

Telecommuting Requirements:

• Reside within commutable distance to the office at Las Vegas, NV
• 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

Nevada, Residents Only: The hourly range for this role is $16.54 to $32.55 per hour. 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.

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 .

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Job Tags

Hourly pay, Minimum wage, Full time, Work experience placement, Local area, Remote job, Work from home, Home office, Shift work, Monday to Friday,

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