Associate Billing Representative Optum Tri-State

Optum in the tri-state region (formerly CareMount Medical, ProHEALTH New York and Riverside Medical Group) offers an interconnected network that enables us to work collaboratively to better coordinate care among our doctors and care teams. Together, we offer you and your family access to more than 2,100 providers, representing 70 specialties, working in 360 medical practices and more than 55 urgent care locations across New York, New Jersey and Southern Connecticut.

We’re a dynamic and growing health care organization, offering a wide range of employment opportunities. We are seeking professional and dedicated individuals to be part of our team, where integrity, respect, accountability, and collaboration are among our core principles. Work with the largest care delivery organization in the world and start doing your life's best work.(sm)

Primary Responsibilities:

• Assist customers with payment processing, invoice explanation, payment due dates and billing questions
• Create documentation for external customers and payers in regard to premium balances as well as billing statements
• Contact customers by phone or in writing to verify data, apprise of billing issues as well as assist with resolution for outstanding balances
• Maintain timely, accurate documentation for all appropriate transactions
• Maintain payment status and billing records through corrections and adjustments
• Consistently meet established productivity, schedule adherence, and quality standard
• Answer patient calls regarding insurance/ billing statements/invoices
• Send Itemized Billing Records upon patient request
• Call insurance to verify patient benefits or provider credentialing
• Update Patient Insurance demographics
• Inform Clinical Staff about denials
• Answer Staff questions related to billing and insurance
• Monitor work queues, analyze trends, and follow up
• Investigate Insurance Claim Denials
• Work closely with the billing group to keep track of accounts receivable
• Review and Code Massage Therapy, Physical Therapy, and Chiropractic Claims
• Work on Projects related to Billing

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:

• Experience with admin/billing in the healthcare industry
• Understanding of Insurance guidelines/ Benefit Verification
• Understanding of HIPAA and other relevant regulations affecting patient information
• Ability to work 3 days/week minimum in the office
• Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation

Preferred Qualifications:

• Communication and Customer Service Skills
• Effective prioritization and multitasking skills - ability to meet deadlines

Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

CareMount Medical, ProHEALTH Care Associates, and Riverside Medical Group (the “Practices”) are all physician owned and led practices having complete authority for all medical decision-making and patient care through their physicians and other licensed professionals. Optum, through its management organizations (“Optum”) provides non-clinical administrative services to support the Practices and their physicians. Neither Optum nor its management companies employs, engages, or supervises physicians or other licensed professionals, or determines or sets the methods, standards, or conduct of the practice of medicine or health care provided by the Practices or by any of their licensed professionals. “Part of Optum” reflects that the Practices are part of Optum’s effort to support forward-thinking physician practices in helping their patients live healthier lives.

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.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.