Major Medical Billing Representative

This position is National Remote. You'll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

The RCM Billing Representative is an entry-level to intermediate individual contributor responsible for accurate and timely invoice creation and claim submission for home infusion services.

This position is full time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00 am - 7:00 pm CST (will be assigned to an 8-hour shift based on business needs). It may be necessary, given the business need, to work occasional overtime.

We offer paid training. Training hours will be based on schedules from 7:00 am - 7:00 pm CST or discussed on your first day.

Primary Responsibilities:

• Process claims focusing on copay assistance and secondary claims after primary adjudication
• Generate and submit accurate invoices and claims timely
• Review open delivery tickets and prioritize daily billing activities
• Identify billing discrepancies and escalate trends to leadership
• Complete account corrections within SLAs
• Resolve payer rejections for clean claim resolution
• Adhere to payer, regulatory, and internal billing guidelines
• Provide customer service to internal and external stakeholders
• Align with organizational mission and values in all interactions
• Perform additional duties as assigned

Required Qualifications:

• High School Diploma/GED or equivalent experience
• 1+ years medical billing or medical collections experience
• Proficient in Microsoft Excel, Outlook, Teams
• Proficient in Adobe Acrobat or Nitro Pro
• Flexible to work assigned shifts during 7:00 am - 7:00 pm CST

Preferred Qualifications:

• Knowledge of ICD-10, HCPCS, NDC, HIPAA
• Pharmacy or medical terminology experience
• Experience with multi-claim databases or clearinghouse platforms
• Experience with medical copay assistance and secondary claims
• Pharmacy infusion background

Telecommuting Requirements:

• Secure handling of company sensitive documents
• Dedicated private work area
• High-speed internet connection per UnitedHealth Group standards

Compensation is hourly, $17.98 - $32.12 per hour, with comprehensive benefits, incentive programs, equity stock purchase, and 401k contributions.