Experienced Credit Balance Clerk – Revenue Cycle Management and Health Insurance Claims Resolution Specialist

Introduction to Optum and Our Mission

Optum, a global organization, is dedicated to delivering care aided by technology to help millions of people live healthier lives. Our team's work directly improves health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. We are committed to advancing health equity on a global scale, and we invite you to join us in making an impact on the communities we serve. At Optum, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities, and the chance to do your life's best work.

Job Overview

We are seeking an experienced Credit Balance Clerk to review and analyze accounts, work queues, and/or reports to identify and resolve unapplied credits and credit balances issued by insurance companies or patients. This role is crucial in resolving credits and initiating takebacks and/or refunds, ensuring that our revenue cycle management is efficient and effective. As a Credit Balance Clerk, you will enjoy the flexibility to telecommute from anywhere within the U.S. and take on challenging tasks while working with a talented team of professionals.

Primary Responsibilities

• Apply knowledge and skills to basic, repeated activities, demonstrating a minimum depth of knowledge and skills in your function
• Respond to standard requests and require assistance in responding to non-standard requests
• Solve routine problems by following established procedures, with others prioritizing and setting deadlines for you
• Review accounts, including Explanation of Benefits (EOB)/Electronic Remittance Advice (ERAs), payments, adjustments, validate patient payments, validate coordination of benefits, and all account comments
• Contact and communicate with insurance companies to gather additional information, as necessary, to ensure that credits are accurate
• Refund overpayments or initiate takeback requests on accounts, conducting appropriate reviews to accurately transfer payments in accordance with established procedures
• Meet quality assurance and productivity standards through identification, reconciliation of credit balance accounts, and/or review of credit balance reports for potential overpayments in accordance with organizational policies and procedures
• Work with others as part of a team, proficient in 10-key and alpha/numeric data entry

Required Qualifications

To be successful in this role, you will need:

• High School Diploma/GED (or higher) OR 4+ years of experience in revenue cycle and health/medical billing and collections
• 2+ years of experience in revenue cycle credit balance and health/medical billing and collections
• 1+ year of experience in Epic
• Intermediate level of proficiency with Microsoft Word, Outlook, and Excel

Soft Skills

In addition to the technical requirements, we are looking for candidates with:

• Ability to work in a fast-paced, deadline-driven environment
• Ability to work effectively in both team and individual environments
• Ability to multi-task, establish priorities, and work independently to meet objectives

Career Growth Opportunities and Learning Benefits

At Optum, we are committed to helping our employees grow and develop in their careers. As a Credit Balance Clerk, you will have access to training and development programs, as well as opportunities to work on complex projects and collaborate with experienced professionals. We believe in promoting from within and providing our employees with the tools and resources they need to succeed.

Work Environment and Company Culture

Our company culture is guided by diversity and inclusion, and we are committed to creating a workplace where everyone feels valued and respected. We believe that diversity creates a healthier atmosphere, and we are an Equal Employment Opportunity/Affirmative Action employer. Our team is passionate about making a difference in the lives of our customers, and we are dedicated to advancing health equity and improving health outcomes.

Compensation, Perks, and Benefits

We offer a competitive salary and a comprehensive benefits package, including incentive and recognition programs, equity stock purchase, and 401k contribution. We also provide a flexible work environment, with the option to telecommute from anywhere within the U.S. Our benefits are subject to eligibility requirements, but we are committed to providing our employees with the support they need to thrive.

Conclusion

If you are a motivated and detail-oriented individual with a passion for revenue cycle management and health insurance claims resolution, we encourage you to apply for this exciting opportunity. As a Credit Balance Clerk at Optum, you will have the chance to make a real difference in the lives of our customers, while working with a talented team of professionals who share your values and commitment to excellence. Don't miss out on this opportunity to join our team and start making a positive impact today!

Apply now and take the first step towards a rewarding and challenging career with Optum. We look forward to receiving your application and discussing this opportunity further.