Collections Representative - Remote in CST or EST

$34,403 - $67,704/Yr

Optum - Dallas, TX

Full-time

Remote - Dallas, TX

5,001-10,000 employees

Insurance Carriers and Related Activities

About the position

The Collections Representative position at Optum involves managing medical accounts receivable and billing processes to improve health outcomes. This full-time role requires flexibility in working hours and offers remote work options for candidates located in the Central or Eastern Time Zones. The representative will perform research on payer guidelines, process claims, and communicate with members and providers to resolve billing issues, all while adhering to company policies and performance goals.

Responsibilities

• Perform research on assigned payer guidelines when processing appeals, corrected claims or denial reasons
• Stay up to date on all payer requirements and changes
• Comply with departmental Business Rules and Standard Operating Procedures
• Focus efforts on decreasing the Accounts Receivable, increasing cash, and/or reducing bad debt
• Interpret explanation of benefits for appropriate follow up action
• Utilize automation tools to verify eligibility, claim status and/or to obtain better billing information
• Create work list through database and manipulate data to analyze for trends and resolve claims for adjudication
• Review and research denied claims by navigating multiple computer systems and platforms, in order to accurately capture data/information for processing
• Communicate and collaborate with members or providers to evaluate claims errors/issues, using clear, simple language to ensure understanding
• Work on various other projects as assigned/needed
• Meet the performance goals established for the position in the areas of efficiency, accuracy, quality, patient, and client satisfaction and attendance

Requirements

• High School Diploma / GED
• Must be 18 years of age OR older
• 2+ years of experience in medical account receivable and/or medical billing/collections in the Healthcare industry
• Computer & phone skills, including working knowledge of Microsoft Windows and navigation, mouse, and keyboarding skills
• Intermediate level of experience with Microsoft Word (creating and editing documents)
• Intermediate level of experience with Microsoft Excel (data entry, sorting/filtering)
• Ability to work any full time (40 hours/week) shift between the hours of 8:00 AM - 5:00 PM CST from Monday - Friday

Nice-to-haves

• Knowledge of full version Adobe (creating and editing documents)
• Medical claims experience
• Medicare OR Medicaid collections experience
• EOB experience

Benefits

• 401(k) matching
• On-the-job training
• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase