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.
As the Lead Billing Representative for Unity Health Network – an Optum Care Delivery Organization, you’ll play a critical role in creating a quality experience that impacts the financial well-being of our patients. In an environment where the patient is at the center of everything we do, the Senior Billing Representative, Group Lead will assist the Department Supervisors by performing combinations of the following activities:
- Coordinate and maintain workflows
- Perform Lead Billing Representative work duties
- Handle escalated issues with both internal and external customers, and within the department.
- Provide training to new and seasoned employees, provide performance input.
- The Lead Billing Representative is a direct point of contact for employees in providing coaching, training, and constructive feedback as well as leadership. If selected for this position, it is required that you successfully complete the UnitedHealth Group new hire training and demonstrate proficiency to continue in the role
This position is full-time (40 hours/week) Monday - Friday. Employees are required to work any of our 8-hour shift schedules during our normal business hours of 7:00am - 5:00pm EST.
It may be necessary, given the business need, to work occasional overtime. Our office is located at Unity Health Network. 2750 Front Street Cuyahoga Falls OH 44221. The position is On-site but has the opportunity to become in a Hybrid set up after 90days.
We offer weeks of on-the-job training. The hours of the training will be based on schedule or will be discussed on your first day of employment.
Primary Responsibilities:
- Performs all tasks of a Lead Billing Representative e or a Senior Patient Financial Services Representative .
- Based on department needs, monitors some of the following: back end operations or functions, front end operations or functions, production tracking, and coverage as needed for patient phone calls, payment posting and aging reports.
- Trains employees and completes other trainings throughout the year.
- Communicates with superiors, peers, employees, internal and external customers, and others, as appropriate, on regular basis, assuring proper flow of information.
- Assists in documenting standard operating procedures and business rules for the department.
- Assists in resolving problems relating to all areas of Patient/Third Party billings and missing information.
- Develops recommendations for action plans based on production and quality issues.
- Responds to patient complaints and escalated issues to assure the appropriate action for resolution occurs.
- Provides input and guidance to staff members in order to ensure continuous improvement in processes.
- Facilitates individual and small group meetings.
- Maintains current knowledge of billing requirements and system practices.
- Maintains working knowledge of industry rules, regulations, policies and laws, including but not limited to: Ohio Prompt Pay, HIPAA, CMS and Medicaid 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:
- 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)
- 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
- Experience escalating/resolving high priority issues with insurance companies
- Ability to review and understand the explanation of benefits
- Ability to type at the speed of 45 WPM (words per minute)
- Ability to work onsite at Unity Health Network. 2750 Front Street Cuyahoga Falls OH 44221
- Ability to work any 8-hour shifts between 7:00am - 5:00pm EST from Monday - Friday including the flexibility to work occasional overtime.
Preferred Qualification:
- 1+ years of leadership experience
- Advanced working knowledge / expertise in eCW Billing system
Soft Skills:
- Ability to resolve calls, avoiding escalated complaints
- Ability to exhibit empathy and be courteous to callers
- Ability to triage and handle escalated situations
- Ability to work in a fast-paced environment
- Ability to adapt to changes
- Ability to develop and maintain client relationships
The hourly range for this role is $19.86 to $38.85 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: T his 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.
Optum Care 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.
OptumCare is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
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