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.

This position is full-time, Monday - Friday. Employees are required to work our normal business hours of 7:55 am - 4:25 pm. Our office is located at 210 Westwood Pl Ste 300, Brentwood, TN 37027.

We offer 4 weeks of paid on-the-job training. The hours of the training will be aligned with your schedule.

Primary Responsibilities:

• Take escalation calls from providers and/or make outbound calls to providers to discuss and resolve outstanding overpayments (95% of your day can be on phones)

• Review and action email mailboxes for various providers

• Run and analyze reports for staff management

• Host and attend various meetings

• Provide claims expertise support by reviewing, researching, investigating, negotiating, and resolving all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities

• Fundamental Execution: Plan, prioritize, organize and complete work to meet established production goals, quotas and deadlines in a fast pace and ever-changing environment

• Communicate professionally with the provider to ensure PRS is meeting the needs and expectations of the client; build a good rapport with the provider contacts by establishing professional working relationships to ensure timely recoveries

• Escalate recovery efforts through many avenues to progress and resolve the situations

• Analyze, identify trends, and provide inventory and or client updates as necessary

• Must meet state and federal compliance policies, reimbursement policies, and contract compliance

• Works independently while acting as a resource and mentor for others.

• Perform 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

• Must be 18 years of age OR older

• 1+ years of healthcare customer service experience

• 1+ years of customer service experience with analyzing and solving customer problems

• Experience with working as a Subject Matter Expert OR Team Lead / Supervisory experience

• High proficiency with computer and Windows PC applications in Microsoft Word (ability to create, copy, send and save documents)

• High proficiency with computer and Windows PC applications in Microsoft Excel (ability to create, copy, send and save spreadsheets)

• Ability to work on site at 210 Westwood Pl Ste 300, Brentwood, TN 37027

• Ability to work any shift between the hours of 7:55 am - 4:25 pm from Monday - Friday

Preferred Qualifications:

• 1+ years of claims OR collections experience

• Provider overpayment recovery experience OR debt collection

• Professional billing experience

• Experience with negotiations and direct client interactions

• Previous work within the community giving back OR volunteering time and resources

• Previous call center experience

Soft Skills:

• Ability to work in a dynamic environment both independently and in a group setting

• Communication and Customer Service skills

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.

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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 .

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