Pharmacy Collections Representative - National Remote

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.

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.

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 7:30am – 6:00pm CST. It may be necessary, given the business need, to work occasional overtime.

We offer 3 - 4 weeks of on-the-job training, Monday – Friday, from normal business hours of 7:30am – 6:00pm CST.

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

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 OR equivalent experience
• Must be 18 years of age OR older
• 6+ months medical billing/collections OR pharmacy billing/collections
• 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 7:30am – 6:00pm CST.

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:

• Strong organizational skills
• Excellent written and oral communications skills
• Must be organized and able to prioritize, plan, and handle multiple tasks/demands simultaneously.
• Demonstrated 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