AR Follow-Up | US Medical Claims Collections Specialist (RCM)

Job Qualifications:

• At least 2 years of experience in Healthcare Revenue Cycle Management (RCM), with a focus on Accounts Receivable (AR) Follow-Up and Denials Management.
• Open to:
• Senior High School graduates and above with at least 16 months of AR experience.
• High School graduates (old curriculum) with at least 24 months of AR experience.
• Experience handling unpaid, underpaid, rejected, and denied claims.
• Knowledge of payer guidelines, timely filing requirements, and denial resolution processes.
• Strong written and verbal communication skills, including appeal letter preparation and account documentation.
• Experience in Professional Billing is required.
• Familiarity with Epic is a plus.
• Detail-oriented with strong analytical and problem-solving skills.
• Willing to work onsite on a permanent basis.

Primary Responsibilities:

·       Follow up on outstanding insurance claims to ensure timely reimbursement.

·       Investigate and resolve unpaid, underpaid, rejected, and denied claims.

·       Contact insurance payers to verify claim status and obtain payment updates.

·       Review payer guidelines and contracts to support payment dispute resolutions.

·       Prepare and submit appeals for denied or underpaid claims.

·       Document account activities, claim updates, and payer communications accurately.

·       Monitor claim status and take appropriate action to drive resolution and payment.

·       Identify billing and reimbursement discrepancies and coordinate with relevant teams for resolution.

·       Manage AR collections and ensure accounts are worked within payer filing deadlines.

·       Handle claim-related emails, calls, and documentation while maintaining quality and compliance standards.

·       Contribute to team goals by meeting productivity, accuracy, and collection targets.

WHAT WE OFFER

• Market Competitive Pay Levels
• Fast Processing! No Exam Hiring
• Retirement Plan
• Medical Plan (HMO) from Day 1 of employment
• Dental, Medical, and Optical Reimbursements
• Life and Disability Insurance
• Paid Time-Off Benefits
• Sick Leave Conversion
• Tuition Fee Reimbursement
• Employee Assistance Program (EAP)
• Annual Performance Based Merit Increases
• Employee Recognition
• Training and Staff Development
• Employee Referral Program
• Employee Volunteerism Opportunity
• All Mandatory Statutory Benefits

WHO WE ARE

• Optum is the health care technology and innovation company of the UnitedHealth Group enterprise along with UnitedHealthcare.
• UnitedHealth Group is a health care and well-being company with a mission to help people live healthier lives and help make the health system work better for everyone.
• We're a leading health solution and care delivery organization. Our work is complex, but our mission is simple: create a healthier world, with you at the center.
• As part of a Fortune 5 enterprise, we are improving the health care experience of over 125 million people around the world.
• Elevate your career with a leading health care company while improving lives.

Join us in evolving health care so everyone can have the opportunity to live their healthiest life. This is your opportunity to be part of a team that's dedicated to Caring. Connecting. Growing together