Senior Billing Representative - Noida, UP
- Optum
- 4 - 7 Years
- Noida, Gurugram
- 3 years ago
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Job Description
Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)
Primary Responsibilities:
- Provide Support to Internal and External Billing Customers / Payers
- 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
- 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
- Conduct training (e.g., on-line demonstration ULearn knowledge base invoice inquiry) with internal and/or external customers/payers (e.g., new account managers new sales staff pricing teams) on how to access, review, and/or remit payment forninvoices
- Collaborate with internal partners (e.g., brokers, account managers) and/or external customers/payers to resolve customer issues
- Provide requested reports and documents (e.g., invoices payment histories 5500 Forms Schedule A/C) 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 and/or determine appropriate medical codes from relevant resources (e.g., EMR physician documentation) in order to generate claims for payment
- Ensure accurate processing and completion of denied claims
- Analyze / Resolve / Reconcile Billing Issues
- Receive billing issues/information (e.g., enrollment contract language pricing explanation of medical benefits) and gather relevant data to resolve
- Seek assistance from internal partners (e.g., Sales Plan Changes Contract Installation Underwriting Clinics Contracting Credentialing) and/or external stakeholders (e.g., individual customers/payers brokers) to resolve billing issues
- Analyze relevant information to determine potential reasons for billing discrepancies
- Ensure/verify source data is valid for billing and that it will be submitted to correct payer
- Reconcile discrepancies identified within customer invoices/billing and reports
- Demonstrate understanding of business partners operations in order to identify appropriate resources for support and information
- Generate and/or distribute reports and documentation (e.g., billing statements) to external customers/payers to inform them of premium balances
- Perform queries on relevant systems (e.g., PeopleSoft Access Great Plains CareTracker Platinum Micro Strategies eCW) to gather data needed to analyze billing discrepancies and issues
- Review / resolve claim edits prior to submission
- Demonstrate Knowledge of Billing Systems, Tools and Processes
- Demonstrate understanding of relevant terminology (e.g., financial medical) required for claims / billing
- Demonstrate understanding of relevant systems, tools, and/or software applications (e.g., Prime ACIS PeopleSoft Great Plains CPS Mainframe UMR Web Portal SharePoint GPS MS Office Lotus Notes Databases EMRs Practice Management Systems CareTracker Platinum Micro Strategies eCW)
- Demonstrate and maintain understanding of state and federal regulatory requirements as they apply to billing operations (e.g.,health-care reform state surcharges CMS)
- Demonstrate and maintain understanding of and comply with billing policies and procedures
- Utilize results from billing resolutions to identify potential corrections/enhancements to billing systems, tools, or processes
- Support / Monitor / Manage Invoices and Account Payments
- Analyze reports against existing billing data and make appropriate changes to ensure billing accuracy
- Review rates from internal teams (e.g., Underwriting Sales Implementation) to ensure accuracy before entering rates into applicable systems
- Generate data queries, reports, and/or research (e.g., member audits bill vs. paid reports) needed to monitor customer accountsand balances
- Modify and/or create invoices (e.g., place in Excel format sum mary level adjustments) as needed to meet specific customer requirements
- Perform quality checks on data entries prior to submitting information to internal and/or external customers/payers/clients
- Create and/or distribute billing operational and performance reports to applicable stakeholders (e.g., senior leadership clients)
- Make and/or submit requested changes to customers/payers accounts when applicable
- Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so
Required Qualifications:
- Commerce degree (B.com/M.com)
- 4+ years experience in business, involving Analyze/Resolve/Reconcile Billing Issues
- Intermediate (or higher) level of Microsoft Excel proficiency, including creating pivot tables for reporting purposes and completing V-lookups
- Understanding of Order to Cash cycle
- Open for evening shifts - :15:30 to 01:00 (late night shift 17:45 to 03:30 during closing period)
Preferred Qualifications:
- Accounting, Finance or related field background
- Experience in billing / invoicing
Employement Category:
Employement Type: Full timeIndustry: Hotels
Functional Area: Customer Service
Role Category: F&B Manager
Role/Responsibilies: Senior Billing Representative - Noida, UP
Contact Details:
Company: OptumLocation(s): Noida, Gurugram
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Optum
About: OptumInsight India Pvt Ltd, a UnitedHealth group company is a leading health services and innovation company dedicated to help make the health system work better for everyone. With more than 115,000 people worldwide, Optum combines technology, data and expertise to improve the delivery, ...
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