Billing Representative

Billing Representative

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

The Billing Representative is responsible for reviewing, validating, and processing medical charge entries through Epic and other billing systems. This role supports revenue cycle operations by managing charge review work queues, claim edits, charge corrections, benefits and eligibility verification, document retrieval, and follow-up activities to ensure accurate and timely billing. The Billing Representative works collaboratively with clinical and administrative teams to resolve billing issues and maintain compliance with payer requirements.

This position is full-time, Monday - Friday. Employees are required to work during our normal business hours of 7:30 am - 5:00 pm PST from Mondays - Thursdays and 7:30 am - 11:30 am PST on Fridays. It may be necessary, given the business need, to work occasional overtime.

This will be on-the-job training and the hours during the training will be aligned to your schedule.

Primary Responsibilities:

• Review and process charge sessions within Epic to ensure accurate and timely billing
• Review and resolve charge review, claim edit, charge router, and follow-up work queues
• Perform manual and electronic charge entry with a high degree of accuracy
• Verify patient insurance benefits, eligibility, and financial class (FSC) information
• Correct billing and registration errors impacting claim submission
• Retrieve and review supporting documentation to facilitate accurate charge capture and claim resolution
• Review anesthesia charges for completeness and verify benefits and eligibility prior to posting charges
• Identify and resolve charge-related claim edits and rejections
• Support billing workflows for Adult Medicine, Pediatrics, and Specialty practices
• Maintain compliance with payer, Medicare, Medicaid, and organizational billing guidelines
• Escalate complex billing and reimbursement issues to management as appropriate
• Recommend process improvements that enhance efficiency, accuracy, and revenue cycle performance
• Assist with other revenue cycle and accounts receivable 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
• 1+ years of medical billing, charge entry, or accounts receivable experience in a healthcare environment
• Working knowledge of medical terminology, insurance billing processes, and healthcare revenue cycle operations
• Experience with claims status review, charge entry and A/R follow-up
• Knowledge of ICD-10, CPT, and HCPCS coding, including appropriate use of modifiers
• Experience verifying patient insurance eligibility and benefits
• Proficiency with Microsoft Outlook, Microsoft Word, and Microsoft Excel
• Ability to work full-time, Monday - Friday. Employees are required to work during our normal business hours of 7:30 am - 5:00 pm PST from Mondays - Thursdays and 7:30 am - 11:30 am PST on Fridays. It may be necessary, given the business need, to work occasional overtime

Preferred Qualifications:

• Experience using Epic Revenue Cycle applications
• Experience with other practice management/billing systems
• Medicare, Medicaid, and commercial payer billing experience
• Knowledge of claim edits

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 attention to detail, organizational skills, and problem-solving abilities
• Ability to manage multiple priorities and meet established productivity standards

*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 salary for this role will range from $18 - $32 hourly 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.