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Technical Denials Representative - Phoenix, AZ; Sacramento, CA

UnitedHealth Group

Phoenix, AZ
Job Code:
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Job Details

Technical Denials Representative - Phoenix, AZ; Sacramento, CA(Job Number:724234)

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.

The Technical Denials Representative position is responsible for determining the reason for payment delinquency, negotiate and advise on collection of denied claims and take appropriate action to recover denied payments. Handling of unresolved inquiries / issues, and responsible for developing, implementing, maintaining and managing organization policies on denial appeal management. The representative will manage their assigned work to ensure Medicaid appeal / filing deadlines are met and achieve optimal payment for services rendered. May work with outside legal counsel and / or outside agencies in more complex collection cases.

Primary Responsibilities:

  • Monitors denial work queues and reports in accordance with policies and procedures and supervisor guidance
  • Prioritizes and reviews cases denied by assigned payers
  • Determines actions required for appeals within contractual timeframes
  • Maintains required levels of productivity and quality
  • Works with other departments and resources to resolve issues, as needed

Job Collections
Primary Location US-AZ-Phoenix
Other Location US-CA-Sacramento
Organization O360 Dignity Health Back Ops
Schedule Full-time
Number of Openings 1
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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