Business Operations Specialist - Temporarily Remote in West Hills, CA

Careers at UnitedHealth Group

We're creating opportunities in every corner of the health care marketplace to improve lives while we're building careers. At UnitedHealth Group, we support you with the latest tools, advanced training and the combined strength of high caliber co-workers who share your passion, your energy and your commitment to quality. Join us and start doing your life's best work. SM


Compassion. It's the starting point for health care providers like you and it's what drives us every day as we put our exceptional skills together with a real feeling of caring for others. This is a place where your impact goes beyond providing care one patient at a time. Because here, every day, you're also providing leadership and contributing in ways that can affect millions for years to come. Ready for a new path? Learn more, and start doing your life's best work. SM

Our teams are helping people from around the world. We can bring out your best as you put your listening, analytical and problem solving skills to work in a setting that is geared to helping improve lives and enhance health care for millions. Here, you'll discover a wealth of pathways for professional growth within Customer Service, Billing, Claims, Enrollment & Eligibility and across our global economy. Join us and find out why this is the place to do your life's best work. SM

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.

The hours for this role are Monday- Friday from 8:00am-5:00pm Training will be on site for the first week then virtual after that. This role will be mostly virtual, but you may need to go into the office from time to time. Our office is located at 8403 and 8401 Fallbrook, West Hills, CA.

This will be a temporarily work from home position*.

Primary Responsibilities:
  • Analyze and apply denials to third party carriers in all media types
  • Comply with departmental Business Rules and Standard Operating Procedures
  • Focus efforts on decreasing the Accounts Receivable, increasing cash, and / or reducing bad debt
  • Interpret explanation of benefits for appropriate follow up action
  • Utilize automation tools to verify eligibility, claim status and / or to obtain better billing information
  • Create work list through database and manipulate data to analyze for trends and resolve claims for adjudication
  • Review and research denied claims by navigating multiple computer systems and platforms, in order to accurately capture data / information for processing
  • Communicate and collaborate with members or providers to evaluate claims errors / issues, using clear, simple language to ensure understanding
  • Conduct data entry and rework for adjudication of claims
  • Work on various other projects as needed
  • Meet the performance goals established for the position in the areas of: efficiency, accuracy, quality, patient and client satisfaction and attendance

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:
  • Bachelor's degree
  • Data entry experience (entering customer information)
  • Experience using Microsoft Excel (ability to create a professional looking spreadsheet, Trims, vlookups, add worksheets, copy / paste, sort, freeze, hide cells, sum, create and add / delete columns; Pivot Tables, handling large data and reconciling)
  • Experience using Microsoft Word to create documents for presentations / public speaking
  • Prior experience with large data handling/reconciling
  • Ability to work any 8-hour shift between the hours of 7:00 am and 5:00 pm, Monday - Friday
  • You will be asked to perform this role in an office setting or other company location, however, may be required to work from home temporarily due to space limitations.
  • Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained.

Preferred Qualifications:
  • Customer service experience
  • Banking experience
  • 2+ years of medical billing operational department
  • 1 year in leadership experience
  • Ability to type 45+ WPM
  • Experience with 10 - key
  • Structured Query Language Experience
  • Tableau user
  • Business Analysis
  • Requirements gathering
  • Power Excel user(nested formulas, VBA, macros, conditional)
  • Access database handling
  • 1+ year of call center experience

Soft Skills:
  • Reliable and interdependent
  • Excellent verbal and written communication skills
  • Excellent customer service skills
  • Demonstrated problem solving skills
  • Good organizational skills
  • Ability to present / demo processes
  • Ability to multi - task, including the ability to type while talking on the phone
  • Ability to work independently and as part of a team
  • Ability to work overtime as needed, based on department needs
  • Ability to work independently and mindset of embracing changes

UnitedHealth Group is an essential business. The health and safety of our team members is our highest priority, so we are taking a science driven approach to slowly welcome and transition some of our workforce back to the office with many safety protocols in place. We continue to monitor and assess before we confirm the return of each wave, paying specific attention to geography-specific trends. At this time, 90% of our non-clinical workforce transitioned to a work at home (remote) status. We have taken steps to ensure the safety of our 325,000 team members and their families, providing them with resources and support as they continue to serve the members, patients and customers who depend on us.

You can learn more about all we are doing to fight COVID-19 and support impacted communities at: click here.

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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