Payment Applications Specialist

This position is Onsite. Our office is located at Cuyahoga Falls, Ohio.

Unity Health Network, part of the Optum family of businesses, is seeking a Payment Applications Specialist to join our team in Cuyahoga Falls, Ohio. Optum is a clinician-led care organization that is changing the way clinicians work and live.

As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone.

At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. Here, you'll work alongside talented peers in a collaborative environment that is guided by diversity and inclusion while driving towards the Quadruple Aim. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together. 

This position has responsibilities for patient accounts, accurate payment posting, and denial management; and customer service functions for premiere Medical Resources, under the supervision of the Supervisor, Patient Financial Services.

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 8:00 am - 5:00 pm. It may be necessary, given the business need, to work occasional overtime.

We offer 12 weeks of on-the-job training. The hours of training will be aligned with your schedule.

Primary Responsibilities:

• Posts patient and insurance payments to the correct account within the prescribed timeframe with a 95% or higher accuracy rate.
• Analyzes and follows up on accounts where underpayments or non-payments have occurred. This includes but is not limited to:
  • Underpayments or "short-pays" from insurance companies.
  • Denials or non-covered service adjustments from insurance companies
  • Following up with insurance companies when payment has not been received within the Prompt Pay Law guidelines, or as otherwise specified contractually.
  • Correcting and rebilling COB/no coverage denials
• Analyzes and resolves accounts on which overpayments have occurred; processes paperwork if needed so refund is issued to appropriate denials.
• Responds to patient, physician and insurance company inquiries regarding various accounts.
• Maintains working knowledge of industry rules, regulations, policies and laws, including but not limited to: Ohio Prompt Pay, HIPAA, CMS and Medicaid guidelines.

Note: The above stated duties are intended to outline those functions typically performed by the incumbent in this position. This description of duties is not intended to be all-inclusive nor to limit the discretionary authority of supervisors to assign additional tasks of a similar nature or level of responsibility.

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 OR equivalent work experience
• Must be 18 years of age OR older
• 1+ years of related experience, including billing in a physician office or billing company environment
• General computer literacy
• General clerical skills and attention to detail are essential
• Communication skills
• Must be able to work under pressure and meet deadlines
• Proficiency with keyboard and 10 key adding machine
• Must reside within 15-20 miles of Cuyahoga Falls, Ohio
• Ability to work 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 8:00 am - 5:00 pm. It may be necessary, given the business need, to work occasional overtime.

Soft Skills:

• The incumbent will have the ability to effectively interact with populations of the patient (and his or her representative) with a sensitivity to the communication needs (other language, deaf or blind) and with an understanding of their needs for self-respect and dignity.
• Committed to providing exceptional service to patients, visitors and internal/external contacts. Strives to provide the highest level of patient satisfaction with each interaction. Committed to treating co-workers' with respect and dignity. Ensures a consistently positive experience for all patients, employees and visitors.
• Adheres to the hospital attendance policy and will make every effort to consistently be punctual when reporting to work and during daily activities.

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 $18 - $32 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.

UnitedHealth Group 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.

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

#RPO #RED

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