Senior HBA Collection and Research Specialist

If you are located within Mainland USA, you will have the flexibility to work remotely* 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, dataand resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefitsand career development opportunities. Come make an impact on the communities we serve as you help us advance health optimizationon a global scale. Join us to start Caring. Connecting. Growing together.

The Senior HBA Collection and Research Specialist position is a member of the Post-Pay Eligibility & Research group within the Hospital Bill Audit (HBA) team and supports our auditors and audit process. The primary responsibility of the role is to perform collections tasks including sending and tracking of collection letters, follow up calls for unresponsive collection, overpayment calculations and updates to client systems. May also participate in client and provider meetings.

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 7:00am - 6:00pm CST. It may be necessary, given the business need, to work occasional overtime.

We offer weeks of on-the-job training. The hours of the training will be aligned with your schedule.

Primary Responsibilities:

• Send and track collection letters to providers after audits have been completed
• Make follow-up calls to providers for unresponsive collection
• Utilize payer claim systems to review contracts between clients and providers to identify contractual rates and guidelines to determine overpayment calculation and refund due from provider
• Document outcome of collection process in appropriate Optum and client payer systems
• Complete annual client compliance training and maintain access to client systems
• Research and respond to client, provider, and other operational inquiries
• Review existing processes and suggest improvements to management
• Complete client claims rework and update Aetna system with all required notes and documents
• Respond to client requests for information concerning rework performed by Optum
• Participates in meetings when needed (e.g., operations, implementations, client/provider)
• Provides updates to manager and lead
• Review existing processes and suggest improvements to management
• 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
• 2+ years of experience in medical claim processing and collections/accounts receivable
• Understanding of payment methodology and the ability to calculate correct payment amounts for claims including, percent of charge, stop loss, DRG, per diem, case rate, etc.
• Proficient computer skills including Microsoft Office suite; Microsoft Word (ability to create, copy, edit, save, and send documents), Microsoft Excel (ability to create, copy, edit, save, and send spreadsheets) and Microsoft Outlook (email and calendar management)
• Ability to work any of our 8-hour shift schedules during our normal business hours of 7:00am - 6:00pm CST, Monday - Friday.

Preferred Qualifications:

• Ability to interpret client-provider contracts and extract necessary information to support the audit process
• Understanding of applicable federal, state, and local compliance regulations
• Understanding of relevant privacy regulations (e.g., HIPAA)

Telecommuting Requirements:

• Reside within Mainland USA
• 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:

• Requires attention to detail, organizational, problem solving and time management skills with flexibility to adjust to changing priorities
• Strong math skills: proficiency in the ability to apply proper payment methodologies and calculate payments
• Effective oral and written communication skills plus the ability to develop effective relationships with our internal and external customers
• Must be self-directed and be able to accomplish work with limited supervision and general work direction
• Confidence in ability to make decisions and support those decisions.

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

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 hourly pay for this role will range from $20.00 - $35.72 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.