Billing Representative - Las Vegas, NV
Company: Optum
Location: Las Vegas
Posted on: April 25, 2024
Job Description:
If you are in Las Vegas , you will have the flexibility to work
from home and the office in this hybrid role 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, 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.
The Billing Representative is responsible for the validation of
charge data received from the clinic settings, creation and
submission of complete and accurate claims, follow-up on claims
status, payment accuracy, appeals and correspondence.
This position is full-time, Monday - Friday. Employees are required
to work our normal business hours of 8:00am - 4:30pm. It may be
necessary, given the business need, to work occasional
overtime.
Our office is located at 2716 N Tenaya Way, Las Vegas, NV .
Employees will be required to work 3 days onsite and 2 days from
home.
We offer 5 days of paid training. The hours during training will be
8:00am to 4:30pm, Monday - Friday. Training will be conducted
onsite.
All Telecommuters will be required to adhere to UnitedHealth
Group's Telecommuter Policy.
Primary Responsibilities:
- Accept imported charges from clinics and complete the data
elements for accurate 1500 claim form data.
- Apply specialty clinic edits as appropriate such as NDCs, lab
values and modifiers.
- Follow-up on claims status and unpaid encounters using payer
portals, contacting insurance plans at specific intervals to ensure
claims are paid timely and accurately.
- Will submit corrected claims, reconsiderations and appeals via
payer portals or paper as required.
- Respond to insurance correspondence received by various methods
such as fax, mail, email.
- Contact clinics, coding, and other resources to assist with
denials related to medical necessity, eligibility, authorizations,
and diagnosis.
- Will submit appeals for payments according to payer
requirements.
- Contact patients as appropriate to obtain information needed to
update insurance information or provide information regarding
coverage issues and coordination of benefits.
- Review encounters for payment demand letters and process bad
debt files as appropriate.
- Complete address updates from electronic update files 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 old OR older
- 1+ years of experience in medical billing including Claims
Status, claim appeals/reconsiderations, charge entry, payment entry
or AR follow-up.
- 1+ years of experience working with and understanding of ICD10
and CPT coding - including modifiers.
- Knowledge of the 1500 form data elements, EOB reason codes,
remarks codes and claims edits as well as NCDs and LCDs
- Basic computer skills to include Microsoft Outlook, Microsoft
Word, and Microsoft Excel
- 1+ years of experience working as Accounts Receivable Clerk,
Medical Biller, Insurance Follow-Up Representative Accounts
Receivable Manager, or accountant.
- Understanding of collections processes, reimbursement
methodologies, state, and federal guidelines for compliant billing
practices
- Ability to work our normal business hours of 8:00am - 4:30pm.
It may be necessary, given the business need, to work occasional
overtime. Preferred Qualifications:
- Medicare and/or Medicaid billing experience
- Understanding of requirements for billing procedures, drugs,
drug waste and office-based labs.
- Familiarity with medical terminology
- Ability to calculate expected reimbursement, co-pays, and
deductibles.
- Experience in using electronic claims editing systems and
clearinghouse. Telecommuting Requirements:
- Reside within commutable distance of 2716 N TENAYA WAY, Las
Vegas, NV
- 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:
- High degree of accuracy and attention to detail
- Verbal and written communications skills to communicate with
providers, payers, and others in a clear and professional manner.
Nevada Residents Only: The hourly range for Nevada residents is
$16.54 - $32.55 per hour. Pay is based on several factors including
but not limited to education, work experience, certifications, etc.
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.
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 .
Keywords: Optum, Sunrise Manor , Billing Representative - Las Vegas, NV, Accounting, Auditing , Las Vegas, Nevada
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