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- Utilize various resources such as third-party publications, procedure manuals and participating contractual agreements, etc. to reconcile accounts
- Advanced knowledge and understanding to process third party rejections using the Payor system and the billing system. Follow-up on open accounts receivable, re-filing and department status procedures
- Utilize Excellian and various systems and demonstrate understanding of procedures for registration/verification modules, Claims Processing system, Web based provider systems, etc, if applicable to position
- Trend analysis, Appeals and Resolves of low payment or underpaid accounts Reports to lead and or supervisor observations of WQ's and workflow processes that may need further review and or development
- Process and resolve complex denials related to coding and site operations (i.e.: CPT related, medical necessity, RAC technical denials etc)
- Ability to deal with difficult revenue cycle situations and resolve issues delaying/preventing payments from 3rd party payers
- May be asked to provide job shadowing/basic training to other team members on the specific nuances of various job functions
- May assist in the design and development of department policies, procedures and tip sheets
- 3+ years of experience in revenue cycle operations
- 2+ years of experience working with Epic
- 1+ years of experience in billing follow up and resolving denials
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Senior Insurance Representative - Minneapolis, United States - Optum
Description
$1,000 Sign-on Bonus for External CandidatesOpportunities at Optum, in strategic partnership with Allina Health. As an Optum employee, you will provide support to the Allina Health account. 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 Revenue Cycle Insurance Specialist Senior assignments include the "RCM Insurance Specialist Associate and Intermediate" duties. The Insurance Specialist Senior may be called upon to provide assistance for projects and escalated issues within the department, assist in the development of the department's policy and procedures, and help provide training/ job shadowing to new employees.
Primary Responsibilities:
Required Qualifications:
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.