Onsite Account Representative - Secondary Insurance Billing - MarinHealth, Northern CA - California, San Rafael

The announced job offer is made public by the firm: UnitedHealth Group and it was included in jobs list the date of: 2022-10-22 in the website greenenergyjobsonline.com.

It is announced that they have a job offer at the category of Array and the jobs location is in the state of California at the city San Rafael, in the country US - at this current ZipCode: 94915

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Under the general guidance of the Supervisor, the Account Representative, Commercial will be responsible for, but not limited to, the following duties: initial and follow up billing; account follow up; correction of errors; appealing claims; working with outside vendors and overall resolution of accounts.

Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 05:30am - 02:00pm PST. Our office is located at 3950 Civic Center Drive San Rafael, CA 94903.

Primary Responsibilities:

• Responsible for timely and correct initial billing of accounts to the correct payers utilizing hospital information and EDI vendor
• Correction of claims, based on personal knowledge and system identified errors to assure claims are submitted accurately
• Performs timely follow up with the payer to determine status of claim and processing of the payment
• Utilizing personal skills developed, performs timely follow up through phone calls, investigative work, re-bills and on-line applications to assure accounts are resolved in a timely and efficient manner
• Responsible for maintaining current and ongoing knowledge of State and Federal guidelines as they pertain to the accurate resolution of accounts
• Responsible for reviewing the Expected Payment variance reports for incorrect payments on accounts
• Responsible for all accounts assigned to assure the hospital receives accurate and timely payment
• Ability to manage work flows to assure accounts are not lost due to timely billing and other preventable errors
• Identified underpayments are reviewed to determine the reasons and appropriate actions taken to correct the discrepancies. These actions may include, but not be limited to phone calls, appeal letters, working with the attending MD and HIM
• Identifies specific problems or trends, develops appropriate tracking tools, and keeps Manager and Director informed
• Responsible for handling all levels of questions and issues from insurance companies, appropriate governmental agencies, patients, and doctor's offices
• Responsible for maintaining productivity within overall established Business Office guidelines. All variances in overall productivity will be evaluated and corrective action developed with Management
• Researches and completes credit/charge corrections and write-offs
• Handles all written correspondence addressed to their area
• Utilizes the Hospital Information system to research accounts in a timely and effective manner
• Maintains copies of appeals and correspondence either at workstation, cash folders or personal filing systems. Copies must be maintained in alphabetic order by year of service
• Correspondence could include: arbitration appeals for Managed Care, 1st report of injuries, follow up letters specific to claims and carriers, ABN's, and TAR's
• Prepares financial agreements, creditors' claims, probate forms, bankruptcy claims and Worker's Compensation liens
• Participates actively in the achievement of organizational and departmental goals
• Attends and participates in in-services and staff meetings. Maintains standards of the organization and department
• Abides by hospital policies on attire, work habits and relationships. Observes confidentiality and decorum in conversation and behavior
• Assists in the orientation of new employees
• 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 higher)
• 1+ years of progressive experience working in a small to medium size acute care hospital business office
• Experience should be specific to account handling from billing to account resolution
• Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation.

Preferred Qualifications:

• Strong working knowledge of all areas related to the resolution of non-Government accounts and the regulatory requirements for each payer
• Overall skills would be specific to the type of accounts handled, whether it is HMO, PPO, Work Comp, County, Champus etc.,

Soft Skills:

• Ability to work tactfully and professionally with patients, family members, hospital staff, medical staff, outside payers and vendors
• Ability to problem solve, multitask efficiently, organize, and prioritize multiple tasks with minimum supervision
• Run outstanding balance reports and research, collect or re-bill when appropriate
• Strong verbal and written communication skills are critical when working with payers (May need to initiate written appeals for contract discrepancies and underpayments)
• Understanding of the overall diversity of our patient population and treating everyone with respect and courtesy
• Comprehension of commercial payer reimbursement to determine contract compliance and payment performance
• Has thorough knowledge of Coordination of Benefits relative to primary versus secondary payers according to contractual and governmental guidelines
• Understanding of the overall diversity of our patient population and treating everyone with respect and courtesy

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

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Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.