Payment Applications Specialist - Cuyahoga Falls, OH

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.

Summary Position: This position has responsibilities for patient accounts, accurate payment posting, and denial management; and customer service functions for premiere Medical Resources, under the supervision of the Supervisor, Patient Financial Services.

This position is full time Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm. It may be necessary, given the business need, to work occasional overtime. Employees are required to work some days onsite and some days from home.

We offer weeks of paid training. The hours during training will be 8:00 am to 5:00 pm CST, Monday - Friday.

If you are within commutable distance to the office at CUYAHOGA FALLS-2750 FRONT ST, you will have the flexibility to work from home and the office in this hybrid role* as you take on some tough challenges.

Primary Responsibilities:

• Posts patient and insurance payments to the correct account within the prescribed timeframe with a 95% or higher accuracy rate.
• Analyzes and follows up on accounts where underpayments or non-payments have occurred. This includes but is not limited to:

o Underpayments or "short-pays" from insurance companies.

o Denials or non-covered service adjustments from insurance companies

o Following up with insurance companies when payment has not been received within the Prompt Pay Law guidelines, or as otherwise specified contractually.

o Correcting and rebilling COB/no coverage denials

• Analyzes and resolves accounts on which overpayments have occurred; processes paperwork if needed so refund is issued to appropriate denials.
• Responds to patient, physician and insurance company inquiries regarding various accounts.
• Maintains working knowledge of industry rules, regulations, policies and laws, including but not limited to: Ohio Prompt Pay, HIPAA, CMS and Medicaid guidelines.

Note: The above stated duties are intended to outline those functions typically performed by the incumbent in this position. This description of duties is not intended to be all-inclusive nor to limit the discretionary authority of supervisors to assign additional tasks of a similar nature or level of responsibility

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 or equivalent experience
• Must be 18 years of age or older
• 2+ years related experience, including billing in a physician office or billing company environment.
• General computer literacy is required.
• General clerical skills and attention to detail are essential.
• Excellent communication skills are required.
• Be able to work under pressure and meet deadlines.
• This position requires proficiency with keyboard and 10 key adding machine.
• Ability to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm. It may be necessary, given the business need, to work occasional overtime.

Telecommuting Requirements:

• Reside within commutable distance to the office at 2750 Front ST, Cuyahoga Falls, OH
• 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

• The incumbent will have the ability to effectively interact with populations of the patient (and his or her representative) with a sensitivity to the communication needs (other language, deaf or blind) and with an understanding of their needs for self-respect and dignity.
• Committed to providing exceptional service to patients, visitors and internal/external contacts. Strives to provide the highest level of patient satisfaction with each interaction. Committed to treating co-workers' with respect and dignity. Ensures a consistently positive experience for all patients, employees and visitors.
• Adheres to the hospital attendance policy and will make every effort to consistently be punctual when reporting to work and during daily activities.

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

The hourly range for this role is $16.88 to $33.22 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

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.

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.