Note: The job is a remote job and is open to candidates in USA. Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The Billing Representative will analyze and apply denials to third party carriers, decrease Accounts Receivable, and collaborate with members or providers to evaluate claims errors. This role requires flexibility to work full-time hours and may involve occasional overtime.
Responsibilities
- Analyze and apply denials to third party carriers in all media types
- 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 databases 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
- Conduct data entry and rework for adjudication of claims
- Work on various other projects as needed
- Meet the performance goals established for the position in the areas of: efficiency, accuracy, quality, patient and client satisfaction and attendance
Skills
- High School Diploma / GED
- Must be 18 years of age or older
- 1+ years of experience in A/R, Billing, or Collections
- 1+ years of healthcare experience
- Ability using computers and Windows PC applications, which includes strong keyboard and navigation skills and ability to learn new computer programs
- Experience with Microsoft Excel - (general spreadsheet navigation, data entry and sorting)
- Experienced with Microsoft Outlook - (create/schedule meetings, calendar invites, and create folders)
- Work experience with data entry
- Ability to work full time. Employees are required to have flexibility to work our normal business hours of 8:00am - 5:00pm. It may be necessary, given the business need, to work occasional overtime
- Certified medical coder or involved with medical coding
- Experience with medical claims processing
- Medical terminology knowledge/experience
Benefits
- Comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase
- 401k contribution
Company Overview
Optum is a healthcare company that provides pharmacy services, health care operations, and population health management. It is a sub-organization of UnitedHealth Group. It was founded in 2011, and is headquartered in Eden Prairie, Minnesota, USA, with a workforce of 10001+ employees. Its website is https://www.optum.com/.Company H1B Sponsorship
Optum has a track record of offering H1B sponsorships, with 648 in 2025, 559 in 2024, 620 in 2023, 851 in 2022, 593 in 2021, 438 in 2020. Please note that this does not guarantee sponsorship for this specific role.
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