Billing Team Lead

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)

The Billing Team Lead reports to the Billing Manager and provides administrative support to the Billing and Revenue Operation Departments. Assist with day-to-day operations by monitoring workload, team performance, and executing biller duties as needed. This position may assist the leadership team in solving complex projects. Positions in this function interact with customers gathering support data to ensure invoice accuracy and also work through specific billing discrepancies. Provide input to policies, systems, methods, and procedures for the effective management and control of the premium billing function. Manage the preparation of invoices and complete reconciliation of billing with accounts receivables. May also include quality assurance and audit of billing activities.

Primary Responsibilities :

• Represents the Company in a professional manner by following all Company policies and procedures
• Uses, protects, and discloses patient's protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
• Establish and maintain effective working relationship with the staff, clinics, ancillary departments, and management
• Consistently exhibits behavior and communication skills that demonstrate commitment to superior customer service
• Lead and provide effective guidance and feedback to the team. Serves as a resource to staff on general billing guidelines
• Maintains current working knowledge of medical billing, CPT, and ICD 10 codes, required modifiers, and encounter data
• Monitor daily workload and create work assignment for the team
• Identify and report trends or issues arising from errors to management
• Perform quality reviews for accuracy and completeness
• Interact with customers gathering support data to ensure invoice accuracy and also work through specific billing discrepancies
• Demonstrate and maintain understanding of state and federal regulatory requirements as they apply to billing operations (e.g., health-care reform; state surcharges; CMS)
• Collaborate with internal partners (e.g., brokers, clinics, coding, account managers) and / or external customers / payers to resolve customer issues
• Seek assistance from internal partners (e.g., Sales; Plan Changes; Contract Installation; Underwriting; Clinics; Contracting; Credentialing; Coding) and / or external stakeholders (e.g., individual customers / payers; brokers) to resolve billing issues
• Ensure accurate processing and completion of denied, rejected, or failed claims
• Review / resolve claim edits prior to submission
• Educate external customers / payers on payment options, billing information (e.g., where to send payment; when invoices are due; information contained on invoices), and / or services (e.g., eService; Invoice Inquiry), as appropriate
• Provide requested reports and documents (e.g., invoices; payment histories; 1500 Forms ) to internal and / or external customers / payers (e.g., brokers; account managers)
• Create and / or distribute documentation to inform internal and / or external customers / payers of new processes, procedures, or general changes to billing operations
• Input information from relevant resources (e.g., EMR; physician documentation) in order to generate claims for payment
• Inform customers / payers of billing problem / issue findings and resolution as appropriate
• Contact external customers / payers to keep them informed of outstanding balances and required payment, as appropriate
• Create and maintain job aids
• Assist management team and work closely with the IT department to ensure provider and facility information is mapped correctly in Allscripts PM, Patient Keeper, and any other PM systems
• Assist in monitoring team performance and metrics
• Conduct training (e.g., on-line demonstration; ULearn; knowledge base; invoice inquiry) with internal and / or external customers / payers (e.g., new account managers; clinics staff, revenue operations staff) on how to access, review, and / or remit payment for invoices
• Demonstrate understanding of business partners' operations in order to identify appropriate resources for support and information
• Research and handle problematic claims
• Generate data queries, reports, and / or research (e.g., member audits; bill vs. paid reports) needed to monitor customer accounts and balances
• Perform biller duties including but not limited to scrubbing of the claims, work held vouchers, review and correction of failed claims, creation of claim batch, etc.
• Must be dependable and well organized
• 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 :

Preferred Qualifications :

Careers at OptumCare. We're on a mission to change the face of health care. As the largest health and wellness business in the US, we help 58 million people navigate the health care system, finance their health care needs and achieve their health and well-being goals. Fortunately, we have a team of the best and brightest minds on the planet to make it happen. Together we're creating the most innovative ideas and comprehensive strategies to help heal the health care system and create a brighter future for us all. Join us and learn why there is no better place to do your life's best work.(sm)

OptumCare is committed to creating an environment where physicians focus on what they do best : care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare's support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.

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 : OptumCare is an Equal Employment Opportunity / Affirmative Action employers 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

About the company

UnitedHealth Group Incorporated is an American multinational managed healthcare and insurance company based in Minnetonka, Minnesota.

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