Business Services Representative I - Insurance Follow-up Team - Remote Opportunity with Competitive Salary & Benefits

Unlock Your Career Potential with Optum - The Everett Clinic

Join our dynamic team as a Business Services Representative I and become an integral part of our Insurance Follow-up Team. As a leading healthcare organization, we're committed to delivering exceptional patient care and outstanding customer service. With a strong focus on innovation and growth, we're seeking talented individuals to drive our success.

About Us

The Everett Clinic, a part of Optum, is a renowned healthcare provider with a rich history of excellence. As a subsidiary of UnitedHealth Group, we're part of a global organization that's passionate about improving the healthcare experience for millions of people. Our culture is built on a foundation of integrity, compassion, and teamwork, and we're dedicated to fostering a work environment that's inclusive, supportive, and rewarding.

Job Overview

As a Business Services Representative I, you'll play a critical role in ensuring that our patients receive the care they need while also managing the business side of our operations. Your primary focus will be on resolving insurance-related issues, handling patient inquiries, and working collaboratively with our clinical teams to deliver seamless care.

Key Responsibilities

• Process follow-up work queue claims to research, accept, or appeal denials using work queue assistant functionality.
• Review coding, reimbursement, and billing requirements by health plan and interpret reason and remark code application.
• Handle health plan correspondence, including documentation requests or appeal responses.
• Update CPT or apply modifier or diagnosis changes per Just Do It criteria using charge correction or edit.
• Provide exceptional customer service to patients, clinical departments, and carriers, resolving service questions and charge disputes promptly and professionally.
• Demonstrate proficiency in job category skills through training, audit, and certification to standard work.
• Be flexible regarding work assignment based on certified skills and job categories to meet customer demand.

Essential Qualifications

To succeed in this role, you'll need:

• A High School Diploma/GED (preferred) or equivalent experience.
• Prior customer service or billing experience (preferred).
• Working knowledge of CPT & Diagnosis Coding, Medical Terminology, and Basic Anatomy.
• Excellent interpersonal and team skills.
• Good computer skills, with a minimum typing speed of 40 wpm.
• The ability to work effectively to meet deadlines and assist others to do the same.
• Competent written and verbal communication skills.
• The demonstrated ability to work effectively with staff, patients, community, and external agencies.

Preferred Qualifications

While not required, the following qualifications can give you a competitive edge:

• CPC Certification.
• Previous experience in a healthcare setting.
• Knowledge of insurance industry trends and regulations.

What We Offer

At Optum - The Everett Clinic, we offer a comprehensive benefits package that includes:

• A competitive salary.
• A $1,500 sign-on bonus for new hires.
• Excellent benefits, including free onsite parking, retirement savings plan, tuition reimbursement, paid time off, and holidays.
• Health insurance.
• Professional growth opportunities.
• A dynamic and supportive work environment.

Work Environment

This is a remote opportunity with hybrid/remote work arrangements available after in-person training. Our team is committed to maintaining a positive and inclusive work culture, and we're dedicated to supporting your well-being and career growth.

Schedule

You'll work 40 hours a week, Monday-Friday, 7:00 am-3:30 pm. While the schedule may vary depending on team and training requirements, we're committed to ensuring a healthy work-life balance.

COVID-19 Vaccination Requirement

As a condition of employment, you'll be required to be fully vaccinated against COVID-19. Additionally, if you're located in a state that mandates COVID-19 booster doses, you'll need to comply with those state requirements.

Ready to Take the Next Step?

If you're a motivated and detail-oriented individual with a passion for delivering exceptional customer service, we encourage you to apply for this exciting opportunity. As a Business Services Representative I, you'll be an integral part of our team, driving our success and advancing your career. Let's discuss how you can become a vital part of our story.

Apply now and let's explore how you can contribute to our mission of improving healthcare for millions of people.