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.

Positions in this function is responsible for the preparation and review of all incoming encounter data and explanation of benefits information received by the Business Office.

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 between the hours of 6:00am - 6:00pm. It may be necessary, given the business need, to work occasional overtime or weekends. Our office is located at 19191 S. Vermont Ave, Torrance, CA.

We offer weeks of paid training. The hours of training will be based on your schedule or will be discussed on your first day of employment.

Primary Responsibilities:

• Consistently exhibits behavior and communication skills that demonstrate Optum’s commitment to superior customer service, including quality, care and concern with each and every internal and external customer

• Reviews encounter data forms for accuracy of CPT and ICD-9 codes, required modifiers, and other encounter data

• Prints insurance claim forms

• Maintains Claim Form log

• Performs electronic claims submission

• Maintains summary report notebooks and confirmation logs

• Reviews insurance claim forms for accuracy and completeness

• Makes necessary claims corrections

• Sorts and reviews payments received by the Business Office

• Calculates insurance contact adjustments

• Prepares payments for data entry according to Payment Calculation policies and procedures

• Applies knowledge of Medicare and Medic-Cal guidelines in reviewing claims to ensure appropriate use of modifiers and CPT/ICD-9 codes

• Corrects claims appearing on edit reports

• Maintains Edit Report binders

• Communicates trends to department supervisors

• Maintains working knowledge of general claims requirements and updates to ICD-9/CPT codes

• Uses, protects, and discloses Optum patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards

• Performs additional duties as assigned

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• High School Diploma / GED

• 1+ years of medical billing experience

• 1+ years of general office experience

• Ability to work onsite at 19191 S. Vermont Ave, Torrance, CA

• Ability to work any of our 8-hour shift schedules between the hours of 6:00am - 6:00pm, Monday - Friday. It may be necessary, given the business need, to work occasional overtime or weekends

• Must be 18 years old OR older

Preferred Qualifications:

• Knowledge of CPT and IDC-10 codes

• Working knowledge of business billing office duties

• Working knowledge of Medicare and Medi-Cal guidelines

• Knowledge of HMO and PPO claims requirements

California Only: The hourly range for this is $16.00 - $28.27 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

Application Deadline : This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

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.

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