Business Services Representative I - Insurance Follow-up Team - Remote Opportunity with Competitive Salary & Benefits

Unlock Your Career Potential with Optum - The Everett Clinic Join our dynamic team as a Business Services Representative I and become an integral part of our Insurance Follow-up Team. As a leading healthcare organization, we're committed to delivering exceptional patient care and outstanding customer service. With a strong focus on innovation and growth, we're seeking talented individuals to drive our success. About Us The Everett Clinic, a part of Optum, is a renowned healthcare provider with a rich history of excellence. As a subsidiary of UnitedHealth Group, we're part of a global organization that's passionate about improving the healthcare experience for millions of people. Our culture is built on a foundation of integrity, compassion, and teamwork, and we're dedicated to fostering a work environment that's inclusive, supportive, and rewarding. Job Overview As a Business Services Representative I, you'll play a critical role in ensuring that our patients receive the care they need while also managing the business side of our operations. Your primary focus will be on resolving insurance-related issues, handling patient inquiries, and working collaboratively with our clinical teams to deliver seamless care. Key Responsibilities Process follow-up work queue claims to research, accept, or appeal denials using work queue assistant functionality. Review coding, reimbursement, and billing requirements by health plan and interpret reason and remark code application. Handle health plan correspondence, including documentation requests or appeal responses. Update CPT or apply modifier or diagnosis changes per Just Do It criteria using charge correction or edit. Provide exceptional customer service to patients, clinical departments, and carriers, resolving service questions and charge disputes promptly and professionally. Demonstrate proficiency in job category skills through training, audit, and certification to standard work. Be flexible regarding work assignment based on certified skills and job categories to meet customer demand. Essential Qualifications To succeed in this role, you'll need: A High School Diploma/GED (preferred) or equivalent experience. Prior customer service or billing experience (preferred). Working knowledge of CPT & Diagnosis Coding, Medical Terminology, and Basic Anatomy. Excellent interpersonal and team skills. Good computer skills, with a minimum typing speed of 40 wpm. The ability to work effectively to meet deadlines and assist others to do the same. Competent written and verbal communication skills. The demonstrated ability to work effectively with staff, patients, community, and external agencies. Preferred Qualifications While not required, the following qualifications can give you a competitive edge: CPC Certification. Previous experience in a healthcare setting. Knowledge of insurance industry trends and regulations. What We Offer At Optum - The Everett Clinic, we offer a comprehensive benefits package that includes: A competitive salary. A $1,500 sign-on bonus for new hires. Excellent benefits, including free onsite parking, retirement savings plan, tuition reimbursement, paid time off, and holidays. Health insurance. Professional growth opportunities. A dynamic and supportive work environment. Work Environment This is a remote opportunity with hybrid/remote work arrangements available after in-person training. Our team is committed to maintaining a positive and inclusive work culture, and we're dedicated to supporting your well-being and career growth. Schedule You'll work 40 hours a week, Monday-Friday, 7:00 am-3:30 pm. While the schedule may vary depending on team and training requirements, we're committed to ensuring a healthy work-life balance. COVID-19 Vaccination Requirement As a condition of employment, you'll be required to be fully vaccinated against COVID-19. Additionally, if you're located in a state that mandates COVID-19 booster doses, you'll need to comply with those state requirements. Ready to Take the Next Step? If you're a motivated and detail-oriented individual with a passion for delivering exceptional customer service, we encourage you to apply for this exciting opportunity. As a Business Services Representative I, you'll be an integral part of our team, driving our success and advancing your career. Let's discuss how you can become a vital part of our story. Apply now and let's explore how you can contribute to our mission of improving healthcare for millions of people. Apply for this job