Collections Representative - Pharmacy

This position is National Remote. You'll enjoy the flexibility to telecommute

• from anywhere within the U.S. as you take on some tough challenges.

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 (40 hours / week). Employees are required to work any of our 8-hour shift schedules during our normal business hours of 7 : 00am - 7 : 00pm CST (Start time can be 7am local time), Monday - Friday. It may be necessary, given the business need, to work occasional overtime or at weekends.

We offer 4 - 8 weeks of on-the-job training. The hours during training will be 7 : 00am - 7 : 00pm CST, Monday - Friday (Start time can be 7am local time.) Training will be conducted virtually from your home.

Primary Responsibilities :

Review open AR and prioritize collection activities.

Develop relationships with payers to obtain remits and resolve root causes.

Assure that timely and accurate follow up activity is performed on all invoices.

Responsible for review and documenting of key accounts.

Identify issues / trends and escalate to Supervisor / Manager when assistance is needed.

Identify and document bad debt write - offs and A / R adjustments.

Identifies any overpayments and / or duplicate payments, with investigation and resolution.

Create refund requests, in accordance with policies and procedures.

Ensures secondary claims are accurately generated and submitted on a timely basis.

Evaluates payments / denials received for correctness and ensures they are applied appropriately.

Provide exceptional Customer service to internal and external customers.

Work with offshore partners to ensure that exceptions are being resolved within the designated standard.

Develop relationships with other departments to provide feedback about root cause issues.

Adhere to Regulatory / Payer Guidelines and policies & procedures.

Other duties as assigned.

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

1+ years of Pharmacy billing / collections OR Home infusion billing experience

Experience using Microsoft Word (edit, create & save documents)

Experience using Microsoft Excel (editing spreadsheets)

Experience using Microsoft Outlook (email)

Experience using Microsoft Teams

Ability to work any of our 8-hour shift schedules during our normal business hours of 7 : 00am - 7 : 00pm CST (Start time can be 7am local time), Monday - Friday. It may be necessary, given the business need, to work occasional overtime or weekends.

Preferred Qualifications :

Infusion Pharmacy experience

Knowledge of NDC, ICD - 10, and HIPAA

Knowledge of benefits verification and prior authorization

Knowledge of explanation of benefits (EOB)

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.

Soft Skills :

Reliable and consistent record of attendance

Ability to follow complex processes and create solutions independently

Strong problem-solving capabilities and time management within a fast-paced environment

Ability to multi-task successfully and meet deadlines in fast-paced environment

Demonstrate a willingness to listen, understand and acknowledge customers, co-workers, leadership and others in a collaborative, respectful and productive manner

Demonstrate good judgement and professional initiative on all matters come across the desk, whether inside or outside the normal scope of the role

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $17.74 - $31.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

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.

#RED