Pharmacy Billing Representative

RCM 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 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 RCM Billing Representative is an entry-level to intermediate individual contributor responsible for accurate and timely invoice creation and claim submission for home infusion services.

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 7:00 am - 7:00 pm CST (will be assigned to an 8-hour shift based on business needs). It may be necessary, given the business need, to work occasional overtime.

We offer paid training. The hours during training will be based on schedule from 7:00 am - 7:00 pm CST or will be discussed on your first day of employment.

Primary Responsibilities:

• Review open delivery tickets and prioritize daily billing activities
• Generate and submit accurate invoices and claims in a timely manner
• Process secondary insurance and copay assistance claims after primary adjudication
• Identify billing discrepancies and escalate trends to leadership
• Complete account correction requests within established SLAs
• Resolve payer rejections for clean claim resolution
• Adhere to payer, regulatory, and internal billing guidelines
• Provide customer service to internal and external stakeholders
• Demonstrate alignment with organizational mission, values, and culture in all interactions
• Perform additional duties as assigned to meet evolving business needs

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 work experience
• Must be 18 years of age OR older
• 1+ years of pharmacy billing and/or pharmacy collections
• Proficiency in Microsoft Programs (Excel, Outlook, Teams)
• Ability to work 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 7:00 am - 7:00 pm CST (will be assigned to an 8-hour shift based on business needs). It may be necessary, given the business need, to work occasional overtime

Preferred Qualifications:

• Knowledge/experience with pharmacy/medical terminology
• Knowledge/experience with multi-claim databases and / OR clearing house platforms
• Knowledge of ICD-10, HCPCS, NDC, HIPAA
• Pharmacy infusion background
• Pharmacy technician background

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.

*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 hourly pay for this role will range from $18.00 to $32.00 per hour 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.