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.

Positions in this function are responsible for daily billing/creating invoices, supporting patient pay activities and financial counseling, and responding and resolving to denials received.

• Daily Billing:
  • Reviews open delivery tickets and prioritize billing activities.
  • Creates invoices that are accurately generated and submitted on a timely basis.
  • Identifies any trends or billing inaccuracies with investigation and resolution, escalating to Supervisor/Manager when assistance is needed.
  • Completes account reviews/correction requests submitted by other departments within established turnaround times.
  • Work closely with front office and prior authorization team to maximize reimbursement
  • Adheres to Regulatory / Payor Guidelines and policies & procedures.
  • Provides exceptional customer service to internal and external customers.
  • Develop relationships with payers to assist with billing and resolve root causes of issues
  • Understands how to research and work closely with insurance carriers for reimbursement requirements
  • Provide exceptional Customer service to patients and support the patient pay team.
  • Enter patient payments, prepare deposits, and balance daily deposit log/ledger
  • Adhere to Regulatory / Payer Guidelines and policies & procedures.
  • Other duties as assigned.
• Financial Counseling:
  • Discuss insurance coinsurance, copays and deductibles with patients and educate them on their insurance coverage as needed
  • Obtain consent and populate financial assistance program applications and copay applications on patients behalf
  • Obtain financial information and signatures from patients when requested by foundations
  • Set up, edit, and maintain payment arrangements in advance or post treatment of patients
  • Properly document all conversations in applicable systems
  • Other duties as assigned
• Denials/Collections:
  • Responsible for the accurate and timely response to denials received. Researching and resolving denials from upstream issues through receiving payment on the claim. Ability to work through various scenarios independently.\
  • Analyzes daily denial management correspondence to appropriately resolve issues
  • Have a vast understanding of the claim life cycle
  • Assure that timely and accurate follow up activity is performed on all invoices that are not paid within 45 days of
  • submission. Responsible for review and documenting of key accounts.
  • Ensures timely payment by identifying denial trends
  • Ability to read and interpret LCD/NCD requirements in regard to CPT and HCPCS denials
  • Identify payer performance trends at the payer level
  • Capable of navigating payer portal
  • Identifies bad debt write-offs and adjustments
  • Process refunds as identified to meet payer guidelines
  • Adheres to regulatory/payer guidelines and policies and procedures
  • Provides exceptional customer service to internal and external customers
  • Other duties as assigned
• Other Roles and Responsibilities:
  • Greeting and checking-in patients as they arrive to our centers
  • Verifies patient insurance information upon check-in
  • Copies insurance cards and driver's license for all new patients
  • Collects patient paperwork and enters patient information into systems, ensuring patient information is accurate and up-to-date
  • Answer calls within the center and market as appropriate
  • General center support i.e. light cleaning, supply ordering/stocking, etc.
  • Receiving packages and mail as appropriate

• High School Diploma / GED or equivalent work experience
• Must be 18 years of age or older
• Knowledge of explanation of benefits (EOB)
• Knowledge of CPT, ICD-10, and HCPCPS coding
• Billing and Collection experience
• Knowledge of benefits verification and prior authorization
• Ability to work 40 hours per week, any shift between the hours of 8am - 8pm EST, Monday - Friday

• Experience in Microsoft Excel (create and edit spreadsheets)
• Experience in Microsoft Word (creating, editing, saving, formatting)
• Experience with Specialty drug and infusion billing in a hospital, HOPD, or community based clinic setting.
• Minimum 2+ years working with medical billing /medical collections, and/or
• accounts receivables, patient pay
• Minimum 2+ years working in Microsoft office, specifically Microsoft Excel, Microsoft Outlook, and Microsoft Word.
• Ability to read and interpret payer contracts and billing guidelines