Healthcare Accounts Receivable SME - Taguig City, NCR

Healthcare Accounts Receivable SME - Taguig City, NCR

UnitedHealth Group
4-7 years
Not Specified

Job Description



Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)
The Accounts Receivable Subject Matter Expert (SME) supports US Healthcare Programs.
Primary Responsibilities:
  • Research/Analyze Accounts Receivable and Outstanding balances by
    • Reading Explanation of Benefits (EOB), Remittance Advise and Denials from Payers where this data is used to build better arguments to drive resolution for the open accounts receivable
    • Researching the web for resources and regulations that are mandated by the federal government for healthcare collections
  • Collaborate and communicate with internal and external partners
    • Communicating with provider representatives, and understands how the US insurance system rules and regulations
    • Use all channels available to communicate, collect and resolve open accounts receivables with patients or payers
  • Negotiate payment terms, payment plans and create arguments that will yield payment success for balance settlements
  • Organize data and collections history of a patient account to build strong arguments to be used for payer settlement initiatives
  • Manage and resolve Customer Disputes and Grievances including finding appropriate financial assistance programs that will reduce patient cost share through foundations or drug copay programs
  • Contributing and improving organization policies on collection practices
  • Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so

Required Qualifications:
  • Completed any 4-year College degree
  • Minimum of 3 years of relevant work experience for candidates with local Insurance Claims experience
  • Minimum of 2 years of experience as a specialist for Provider Healthcare Collections or Healthcare Claims supporting Appeals or Grievances departments
  • SMEs supporting these processes with 1.5 years of experience are also welcome to apply
  • Proficient in US Healthcare billing and coding regulations as it relates to reimbursement
  • Excellent communication skills, both oral and written
  • Self-sufficient and results-oriented individual who is focused to achieve goals
  • Temporary Work at Home Setup is available and candidates must be amenable to work in our offices in Quezon City, Alabang, Taguig City or Cebu City in case return to office is required

Preferred Qualification:
  • Graduate of Business or Medical Allied courses

What We Offer:
  • Market Competitive Pay Levels
  • Retirement Plan
  • Annual Performance Based Merit Increases
  • Medical Plan (HMO)
  • Dental, Medical and Optical Reimbursements
  • Life and Disability Insurance
  • Tuition Reimbursement
  • Paid Time-Off Benefits
  • Sick Leave Conversion
  • Employee Assistance Program (EAP)
  • Recognition
  • Training and Staff Development
  • Employee Referral Program
  • Employee Volunteerism Opportunity

Your role is critical in allowing our members, families, facilities and health professionals to have greater confidence in the exceptional care we provide. And for you, an everyday opportunity to do your life's best work.(sm)

Job Details

Careers with Optum. Here's the idea. We built an entire organization around one giant objective make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm) Diversity creates a healthier atmosphere: Optum 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. Optum is a drug-free workplace. © 2021 Optum Global Solutions (Philippines) Inc. All rights reserved.

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