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Senior Account Receivable Clerk - Melville, NY

UnitedHealth Group

Melville, NY
Job Code:
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Job Details

Senior Account Receivable Clerk - Melville, NY(Job Number:711952)

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.

Positions in this function perform a variety of duties related to billing and collection. Reviews the accuracy of payments to identify denial / underpayment trends. Submits technical appeals to carriers.

Primary Responsibilities:
  • Reviews the accuracy of payments to identify denial / underpayment trends:
    • Confirms account balance reflects accurate reimbursement rate
    • Confirms plan code on account represents correct plan code of the carrier to reimbursement claim
    • Recode if appropriate, order rebill, refers to Credit Collection to repost
    • Identifies claims with potential systemic issues
    • Reviews payment and denials in conjunction with Contract Management and the carrier’s contract to determine if claim was adjudicated correctly
    • Initiates follow up calls and / or spreadsheets to carrier to confirm claims will be reprocessed according to contract
    • Requests documentation needed by carrier via the TRAC system, Medical Records Quic, DRG charges coding request
    • Initiates technical appeals to carriers to overturn denial received
    • Writes appeals, follow-up on appeals and has ability to retrieve letters
  • Maintains and reconciles records
  • Performs related duties, as required
  • Allscripts knowledge
  • Receives, reviews and processes coverage denials and appeal responses received from third party payers
  • Assists healthcare team members in using and updating department computer systems to keep track of denials and appeals activity
  • Generates reports summarizing departmental activities and metrics, as requested by management
  • Billing and follow-up

Job Accounts Receivable
Primary Location US-NY-Melville
Other Location 
Organization O360 Northwell Back Ops
Schedule Full-time
Number of Openings 2
Apply on the Company Site

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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