Join Optum, a global leader dedicated to improving health outcomes through innovative technology and compassionate care. We connect individuals with the vital resources they need to thrive, fostering a culture of inclusion, collaboration, and continuous growth. Embark on a career where you can truly make a difference and help us advance health optimization worldwide. We are currently seeking a Collections Representative with expertise in RCM or AR Calling to contribute to our mission.

As a Collections Representative, you will be instrumental in reviewing outstanding insurance balances to resolve claim payment issues. This involves collaborating with payers, patients, and clients as needed.

You will analyze data to identify trends and propose solutions for improving first-pass denial rates and reducing overall AR aging. Ensuring all tasks are completed within established turnaround times and quality standards is paramount.

Key duties include analyzing Explanation of Benefits (EOBs) and claim denials, identifying trends that impact financial performance and operational efficiency, and contributing to process improvements. You will also perform other assigned duties and adhere to all company policies and directives, including those concerning work location, team assignments, and flexible work arrangements.

We are looking for candidates with at least 12 months of experience in healthcare accounts receivable, specifically in denial management. A strong understanding of the complete accounting cycle and claim lifecycle is essential.

Functional knowledge of HIPAA rules and regulations, along with experience in privacy laws and information access, is required. You should possess in-depth working knowledge of various applications relevant to RCM workflows and a solid understanding of medical insurance types (HMO, PPO, Medicare, Medicaid, Private Payers).

Proficiency in American English with a neutral accent is necessary, alongside strong skills in MS Office, particularly Excel and Outlook. Candidates must demonstrate excellent communication abilities, sound judgment, critical thinking, and problem-solving skills. Efficient and accurate keyboarding skills are also a must, complemented by a strong work ethic and professionalism committed to client and patient satisfaction.