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Billing Quality / Audit Representative - Pittsburgh, PA

UnitedHealth Group

Pittsburgh, PA
Job Code:
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Job Details

754257 Billing Quality Audit Representative Pittsburgh PA

Billing Quality / Audit Representative - Pittsburgh, PA (754257)

Position Description

Position Description:
Optum360 is a dynamic new partnership formed by Dignity Health and Optum to combine our unique expertise. As part of the growing family of UnitedHealth Group, we'll leverage all our resources to bring financial clarity and a full suite of Revenue Management services to Healthcare Providers, nationwide.
If you want to achieve more in your mission of healthcare, you have to be really smart about the business of healthcare. Challenge yourself, your peers, and our industry by shaping what healthcare looks like and doing your life's best work.SM

In an environment where the patient is at the center of everything that we do the individuals in this position typically reconciles medical claims for the purpose of collecting revenue for the organization. They work with patient, client and/or Third Party insurance bills, and may work on one or more of these processes on a daily basis.

Primary Responsibilities:
  • Focused efforts on increasing cash and reducing bad debt. 
  • Research denied claims
  • Complete refunds/adjustments to customer's accounts, while providing necessary back-up information in order to maintain accuracy. 
  • Contact Third Party carriers to follow up on denied and un-responded claims. 
  • Analyze and denials Process and review claims 
  • Evaluate and respond to all aspects of written billing inquiries from the patient or their representative in order to resolve billing issues 
  • Make have contact with insurance carriers, clients, patients and/or other outside sources 
  • Regular research involving both the web and billing systems 
  • May be a certified Medical Coder and/or involved with medical coding. 
  • Maintain Compliance and HIPAA standards at all times Meet or exceed daily production standards Meet or exceed daily quality standards Ability to work on various other projects as needed
Required Qualifications:
  • High School Diploma or GED
  • 1+ year of healthcare experience in A/R, billing or customer service
  • Access experience - data entry
  • Excel experience - sorting, creating and editing spreadsheets
Preferred Qualifications:
  • Some college (or higher)
  • Knowledge of ICD10 and diagnoses codes
Soft Skills: 
  • Excellent communication skills 
  • Demonstrated problem solving skills 
  • Good organizational skills 
  • Data entry skills 
  • Ability to work independently and as part of a team
Physical Requirements and Work Environment:
  • Frequent speaking, listening using a headset, sitting, use of hands/fingers across keyboard or mouse, handling other objects, long periods working at a computer
  • Service center environment with moderate noise level due to Representatives talking, computers, printers, and floor activity
Careers with OptumInsight. Information and technology have amazing power to transform the Healthcare industry and improve people's lives. This is where it's happening. This is where you'll help solve the problems that have never been solved. We're freeing information so it can be used safely and securely wherever it's needed. We're creating the very best ideas that can most easily be put into action to help our clients improve the quality of care and lower costs for millions. This is where the best and the brightest work together to make positive change a reality. This is the place to do your life’s best work.SM

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.
Keywords: billing, claims, medical claims, healthcare claims,  office, UnitedHealth Group, Optum,  training class, customer service representative, customer service, CSR, Data Entry, adjustments, phone support

Job Details

  • Contest Number754257
  • Job TitleBilling Quality / Audit Representative - Pittsburgh, PA
  • Job FamilyBilling
  • Business SegmentOptumInsight

Job Location Information

  • Pittsburgh, PA
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelIndividual Contributor
  • ShiftDay Job
  • TravelNo
  • Telecommuter PositionNo
  • Overtime StatusNon-exempt

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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