UnitedHealth Group • Brandon, FL 33508
Job #2681304823
For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.
The Billing Representative reports to the Billing Manager and is responsible for performing medical billing functions and provide administrative support to the Billing and Collections department. Positions in this function interact with customers and ancillary departments gathering support data to ensure invoice accuracy and work through specific billing discrepancies. Manage the preparation of invoices and complete reconciliation of billing with accounts receivables. May also include quality assurance and audit of billing activities.
This is a hybrid position and will require two days (Tuesday and Thursday) onsite at the office located at: 5130 Sunforest Drive, Tampa, FL 33634.
Primary Responsibilities:
Consistently exhibits behavior and communication skills that demonstrate commitment to superior customer service, including quality and care and concern with each and every internal and external customer
Represents the Company in a professional manner, following all Company policies and procedures
Uses, protects, and discloses Optum Care patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
Ability to establish and maintain effective and positive working relationship with staff and management
Ensures the timely submission of primary and secondary claims
Maintains current working knowledge of CPT and ICD 10 codes, required modifiers and encounter data
Performs electronic claims submission
Notifies management of issues arising from erroneous codes, missing information, and error/edits messages
Analyze relevant information to determine potential reasons for billing discrepancies and changes
Seek assistance from internal partners (e.g., Coding; Credentialing; Clinics; Contracting) and/or external stakeholders (e.g., individual customers/payers; brokers) to resolve billing issues
Reviews insurance claim forms for accuracy and completeness. Makes necessary corrections
Demonstrates and applies knowledge of Medicare and Medicaid guidelines in reviewing claims to ensure appropriate use of modifiers and CPT/ICD 10 codes
Review medical documentation to confirm appropriateness of codes when necessary
Corrects claims appearing on Edit Reports
Communicates system and claim formatting issues to the IT department and Billing Manager
Serves as a resource to Optum Care staff on general billing guidelines
Demonstrate understanding of business partners' operations to identify appropriate resources for support and information
Perform quality checks on data entries prior to submitting information to internal and/or external customers/payers/clients
Inform customers/payers of billing problem/issue findings and resolution as appropriate
Contact external customers/payers to keep them informed of outstanding balances and required payment, as appropriate
Demonstrate and maintain understanding of state and federal regulatory requirements as they apply to billing operations (e.g., health-care reform; state surcharges; CMS)
May conduct training (e.g., on-line demonstration; knowledge base; invoice inquiry) to co-workers (e.g., new staff members, collection/cash posting teams) on how to access, review, and/or submit claims for payments
Must be dependable and well organized
Performs additional 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, G.E.D. or equivalent
CMC, CPC-A Certification
1+ years of related job experience
CPT/ICD 10 codes experience
Preferred Qualifications:
Coding experience
HMO/managed care, Medicare experience
Allscripts, eCW, Athena, and/or RCX system experience
PCP and Hospitalist billing and coding experience
Bilingual in English and Spanish
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: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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 .
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
UnitedHealth Group • Tampa, FL 33603 • 3 Days Ago
UnitedHealth Group • Tampa, FL 33603 • 7 Days Ago
UnitedHealth Group • Tampa, FL 33603 • 9 Days Ago
UnitedHealth Group • Lakeland, FL 33806 • 9 Days Ago
UnitedHealth Group Inc. • Tampa, FL 33602 • Today
Florida Technical College • Tampa, FL 33607 • Today
Jobconversion, LLC • Tampa, FL 33694 • Apr 12
Maxion Research • Tampa, FL 33694 • 10 Days Ago