Campus Pride Jobs

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 startCaring. Connecting. Growing together.

The A/R Billing Clerk position is responsible for validating patient's insurance coverage, processing recurring rentals, claims coding, claims billing including price validation, assisting patient accounts with billing discrepancies, payment posting and working denials in CareTend management software. They are responsible for follow up with payers for more information or payment. Southwest Medical Pharmacy and HME processes an average 22,000 claims per month. This total includes an average 15,000 electronic claims and 5,000 paper claims each month. The A/R Billing Clerks are responsible for follow up on an average 4,000 claims per month. They process all of the credits and corrected billing for patients and insurances.

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 8a:00 m - 4:30 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.

The first 4-6 weeks will be onsite for training and shadowing.

Once training is complete, you will transition to a hybrid schedule, working onsite and remote from home.

If you are within commutable distance to the office at Las Vegas, NV, 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:

• Interact with customers gathering support data to ensure invoice accuracy and also work through specific billing discrepancies
• Provide input to policies, systems, methods, and procedures for the effective management and control of the premium billing function
• Educate customers regarding the availability of receiving invoices and remitting payments through online applications
• Monitor outstanding balances and take appropriate actions to ensure clients pay as billed
• Manage the preparation of invoices and complete reconciliation of billing with accounts receivables
• May also include quality assurance and audit of billing activities
• Resolve most questions and problems, and refers only the most complex issues to higher levels

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
• Necessary to be 18 years of age OR older
• 2+ years of experience with accounts receivable in Multi-Specialty (ex. Adult Medicine, OBGYN, Pediatrics, Cardiology, Pain Management, Urgent Care)
• Ability to review and understand the explanation of benefits
• 2+ years of experience with claims processing or claims appeals/reconsiderations
• Medical terminology knowledge
• Basic computer skills (i.e., Microsoft office and Microsoft Excel proficiency)
• Experience with and understanding of ICD10 and CPT coding - including modifiers
• Ability to type at the speed of 45 WPM (words per minute)
• Ability to work onsite at 2716 Tenaya Way, Las Vegas, NV
• Ability to work any 8-hour shifts between 8:00 am - 4:30 pm from Monday - Friday including the flexibility to work occasional

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