Senior Recovery Resolution Representative

About the role

This position is Onsite at 12 Cadillac Drive, Suite 300 Brentwood, TN 37027. Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together.

Schedule & training

This position is full-time, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:55 am - 4:25 pm. It may be necessary, given the business need, to work occasional overtime. We offer weeks of on-the-job training. The hours of the training will be during normal business hours.

Work environment

This is a high-volume, customer service and collections environment. You must be efficient, productive, and detail-oriented when interacting with providers and members via phone and electronic communication.

Primary Responsibilities

• Take inbound calls from providers and/or make outbound calls to providers to discuss and resolve outstanding overpayments (95% of your day can be on phones)
• Provide claims expertise support by reviewing, researching, investigating, negotiating, and resolving all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities
• Fundamental Execution: Plan, prioritize, organize and complete work to meet established production goals, quotas and deadlines in a fast pace and ever-changing environment
• Communicate professionally with the provider to ensure PRS is meeting the needs and expectations of the client; build a good rapport with the provider contacts by establishing professional working relationships to ensure timely recoveries
• Escalate recovery efforts through many avenues to progress and resolve the situations
• Analyze, identify trends, and provide inventory and or client updates as necessary
• Must meet state and federal compliance policies, reimbursement policies, and contract compliance
• Works independently while acting as a resource and mentor for others
• Perform other duties as assigned

Required Qualifications

• High School Diploma / GED
• Must be 18 years of age OR older
• 1+ years of experience in claims, collections, billing, or handling overdue payments
• 1+ years of customer service with analyzing and solving customer problems
• Experience with Microsoft Word (create correspondence and work within templates), Microsoft Excel (data entry, sort / filter, and work within tables) and Microsoft Outlook (email and calendar management)
• Ability to work full time onsite at 12 Cadillac Drive, Suite 300 Brentwood, TN 37027
• Ability to work full-time, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:55 am - 4:25 pm. It may be necessary, given the business need, to work occasional overtime

Preferred Qualifications

• Call center experience
• Professional billing experience
• Provider overpayment recovery experience or debt collection
• Experience with negotiations and direct client interactions
• Experience working within the healthcare industry
• Work experience within the community giving back or volunteering time and resources

Soft Skills

• Ability to work in a dynamic environment both independently and in a group setting
• Strong Communication and Customer Service skills

Pay

The hourly pay for this role will range from $20.00 to $36.00 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc.

Benefits

In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives.