Medical Claims Rep - Self Pay - Atrius Health

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.

Location: Chelmsford, MA- Hybrid schedule (three days in office and two days remote)

Department: Medical Billing

Schedule: Monday- Friday 8:00a- 4:30p

Position in this function is under general supervision, is responsible for timely and accurate follow up and resolution of all unpaid patient balances. Responds to a high volume of patient calls generated from self-pay statements, analyzes self-pay balances to determine patient responsibility, obtains and enters accurate insurance information, submits services to the insurance carrier, establishes payment plans, processes patient payments, researches all returned mail and prepares non-collectible accounts for the collection agency. Typically reports to Patient Billing Supervisor.

Primary Responsibilities:

• Answers phone calls in a high volume call center environment, fielding calls from patients, insurance carriers, attorneys, and third-party agents, practice staff and clinicians. Maintains composure and professional communications with difficult patients and insurers during financial collection discussions
• Works toward monthly goals of customer service standards and patient financial collections
• Investigates and resolves billing problems using various data and reference material on hand including computer reports, explanation of benefit material, phone inquires and web-site pages
• Researches the non-payment of outstanding balances in a timely and accurate manner. This includes patients, insurance companies, or other third party liability, with focus on self-pay. Resolve, update and resubmit to insurer as appropriate. This includes working, processing and completing monthly assignments for all accounts
• Initiates actions in attempt to collect outstanding patient balances such as contacting patients directly, negotiating payment arrangements and settlements, writing and sending letters and/or final notices and referring patients to third party agency for further collection actions
• Initiates contact to patients for any missing or erroneous demographic and insurance information, update and process as necessary
• Collects and processes patient payments, entering credit card payments into online tool and may perform posting payments into billing system for certain accounts
• May review and process patient refunds in response to patient overpayments and patient accounts that have overpayments and bad debt
• Handles and processes bankruptcy notifications and claims
• Provides billing statements for various requests including third party agencies including medical expense verifications and health care reimbursement accounts
• Responds to patient billing inquiries sent via public web-site or e-mail
• Perform investigation using available sources of information to locate updated address/contact information on returned patient billing statements
• Performs 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 (or equivalent education, training or experience)
• 2+ years of experience working with third party billing practices, (experience with physician's billing preferred)
• 2+ years of experience working with third party billing practices, (experience with physician's billing preferred)
• Proven knowledge of ICD-9, CPT-4 and HCPCS coding
• Knowledge and experience with medical terminology, strong computer skills, attention to detail and problem-solving skills are required
• Proven outstanding customer service and excellent communication skills are necessary to interact with third party agents and patients both verbally and in writing
• Proven ability to work in a fast paced environment and flexibility in adapting to changes in policies, regulations and procedures
• Proven ability to use all electronic tools and applications relevant to the performance of the duties of the position, including but not limited to phone, keyboard, computer and computer applications
• Proven to perform all job functions in compliance with applicable federal, state, local and company policies and procedures.

WORKING CONDITIONS / PHYSICAL DEMANDS

• Busy office environment with frequent deadlines and interruptions.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.98 to $32.12 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

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.

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

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