Business Operations Specialist - Temporarily Remote in West Hills, CA
Vacancy expired!
Healthcare isn't just changing. It's growing more complex every day. ICD - 10 Coding replaces ICD - 9. Affordable Care adds new challenges and financial constraints. Where does it all lead? Hospitals and Healthcare organizations continue to adapt, and we are vital part of their evolution. And that's what fueled these exciting new opportunities.Who are we? Optum360. We're a dynamic new partnership formed by Dignity Health and Optum to combine our unique expertise. As part of the growing family of UnitedHealth Group, we'll leverage our compassion, our talent, our resources and experience to bring financial clarity and a full suite of Revenue Management services to Healthcare Providers, nationwide.The hours for this role are Monday- Friday from 8:00am-5:00pm Training will be on site for the first week then virtual after that. This role will be mostly virtual, but you may need to go into the office from time to time. Our office is located at 8403 and 8401 Fallbrook, West Hills, CA.
Primary Responsibilities:- Analyze and apply denials to third party carriers in all media types
- Comply with departmental Business Rules and Standard Operating Procedures
- Focus efforts on decreasing the Accounts Receivable, increasing cash, and / or reducing bad debt
- Interpret explanation of benefits for appropriate follow up action
- Utilize automation tools to verify eligibility, claim status and / or to obtain better billing information
- Create work list through database and manipulate data to analyze for trends and resolve claims for adjudication
- Review and research denied claims by navigating multiple computer systems and platforms, in order to accurately capture data / information for processing
- Communicate and collaborate with members or providers to evaluate claims errors / issues, using clear, simple language to ensure understanding
- Conduct data entry and rework for adjudication of claims
- Work on various other projects as needed
- Meet the performance goals established for the position in the areas of: efficiency, accuracy, quality, patient and client satisfaction and attendance
- Bachelor's degree
- Data entry experience (entering customer information)
- Experience using Microsoft Excel (ability to create a professional looking spreadsheet, Trims, vlookups, add worksheets, copy / paste, sort, freeze, hide cells, sum, create and add / delete columns; Pivot Tables, handling large data and reconciling)
- Experience using Microsoft Word to create documents for presentations / public speaking
- Prior experience with large data handling/reconciling
- Ability to work any 8-hour shift between the hours of 7:00 am and 5:00 pm, Monday - Friday
- You will be asked to perform this role in an office setting or other company location, however, may be required to work from home temporarily due to space limitations.
- Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained.
- Customer service experience
- Banking experience
- 2+ years of medical billing operational department
- 1 year in leadership experience
- Ability to type 45+ WPM
- Experience with 10 - key
- Structured Query Language Experience
- Tableau user
- Business Analysis
- Requirements gathering
- Power Excel user(nested formulas, VBA, macros, conditional)
- Access database handling
- 1+ year of call center experience
- Reliable and interdependent
- Excellent verbal and written communication skills
- Excellent customer service skills
- Demonstrated problem solving skills
- Good organizational skills
- Ability to present / demo processes
- Ability to multi - task, including the ability to type while talking on the phone
- Ability to work independently and as part of a team
- Ability to work overtime as needed, based on department needs
- Ability to work independently and mindset of embracing changes
Vacancy expired!