Collections Representative – Pharmacy

This position is National Remote. You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. 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. 

If you’re ready to talk about groundbreaking interactions, let’s talk about what happens when a firm that touches millions of lives decides to gather results from millions of prescriptions every month and analyze their impact. Let’s talk about smart, motivated teams. Let’s talk about more effective and affordable healthcare solutions. This is caring. This is great chemistry. This is the way to make a difference. We’re doing all this, and more, through a greater dedication to our shared values of integrity, compassion, relationships, innovation, and performance.  Join us and start doing your life’s best work.^SM

As a Collection Representative your primary function will be to contact payers regarding outstanding accounts receivables. Handle unresolved inquiries/issues. Responsible for adhering to the collections process and maintaining and organization policies on collection practices. 

As the Collections Representative you will be responsible for collecting receivables that are over 90 days old, identifying debt write-offs and adjustments. You will be contacting customers to determine the reason for the payment delinquency and negotiating and advising on collections of overdue bills and take appropriate action to recover payment. Metrics will be expected productivity to work 30 claims on average per day. Responsible for developing, implementing, maintaining, and managing organization policies on collection practices. May work with outside legal counsel and/or outside agencies in more complex collection cases.

This position is full-time (40 hours/week) Monday – Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:30 am – 6:00 pm CST. It may be necessary, given the business need, to work occasional overtime or weekends.

We offer weeks of training. The hours of the training will be based on schedule or will be discussed on your first day of employment.

  

Primary Responsibilities:

• Analyzes daily denial management correspondence to appropriately resolve issues
• Reviews and resolves accounts assigned via work lists daily as directed by supervisor
• Ability to communicate effectively in written and oral form
• Ability to multitask and function in a fast-paced environment
• Ability to prioritize and problem-solve
• Research root cause to report to Supervisor
• Identify payer performance trends at the payer level
• Capable of navigating payer portal
• Identifies bad debt write-offs and adjustments
• Adheres to regulatory / payer guidelines and policies and procedures
• Provides exceptional customer service to internal and external customers
• 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 
• 6+ months of medical OR pharmacy billing OR collection experience 
• Computer skills, including working knowledge of Microsoft Windows and navigation, mouse, and keyboarding skills
• Knowledge of explanation of benefits (EOB)
• Knowledge of CPT, ICD-10, and HCPCPS coding
• Knowledge of benefits verification and prior authorization
• Ability to work any of our 8-hour shift schedules during our normal business hours of 7:30 am – 6:00 pm CST from Monday – Friday including the flexibility to work occasional overtime or weekends based on business need

  

Preferred Qualifications:

• 1+ years of experience in a related environment (i.e., office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools
• Experience with PBM in billing / collections
• Experience in Microsoft Excel (create and edit spreadsheets)
• Experience in Microsoft Word (creating, editing, saving, formatting)
• Home Infusion Experience

  

Telecommuting Requirements:

• 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:

• Organizational skills
• Written and oral communications skills
• Must be organized and able to prioritize, plan, and handle multiple tasks/demands simultaneously
• Critical thinking skills
• Ability to verbally articulate and communicate with manager, team members, and customers

  

*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 $17.74 – $31.63 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. 

   
 
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