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Refund Representative - Rancho Cordova, CA

UnitedHealth Group

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Job Details

754911 Refund Representative Rancho Cordova CA

Refund Representative - Rancho Cordova, CA (754911)

Position Description

Position Description:

Healthcare isn’t just changing. It’s growing more complex every day. ICD-10 Coding replaces ICD-9. Affordable Care adds new challenges and financial constraints. Where does it all lead? Hospitals and Healthcare organizations continue to adapt, and we are vital part of their evolution. And that’s what fueled these exciting new opportunities. 


Who are we? Optum360. We’re 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 our compassion, our talent, our resources and experience to bring financial clarity and a full suite of Revenue Management services to Healthcare Providers, nationwide. 

If you’re looking for a better place to use your passion, your ideas and your desire to drive change, this is the place to be. It’s an opportunity to do your life’s best work.

Primary Responsibilities:
  • Interact with insurance providers gathering support data to ensure invoice accuracy and work through specific collection discrepancies
  • Provide input to policies, systems, methods, and procedures for the effective management and control of the premium collection function
  • Monitor outstanding balances and take appropriate actions to ensure claims are paid as billed
  • Ensuring the accuracy of the refunds requested or credit balance resolution
  • May also include quality assurance and audit of collections activities
  • Moderate work experience within own function
  • Some work is completed without established procedures
  • Basic tasks are completed without review by others
  • Supervision / guidance is required for higher level tasks
Required Qualifications:
  • High School Diploma / GED (or higher)
  • 1+ years of experience in Refunds or Credits in a Medical field or Medical setting
  • Ability to read and understand payer contracts
  • Experience in using Microsoft Excel to create and modify spreadsheets
  • Ability to work 8-hours between 6:00 am - 5:00 pm Monday through Friday and available to work overtime as business needs dictate
Preferred Qualifications:
  • 3+ years of experience in medical refunds or credits
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.

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 Number754911
  • Job TitleRefund Representative - Rancho Cordova, CA
  • Job FamilyBilling
  • Business SegmentOptumInsight

Job Location Information

    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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