UnitedHealth Group Revenue Recovery Resolution Supervisor- Ontario, CA in Ontario, California
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)
The Recovery Resolution Supervisor is responsible for supervising the staff, setting goals for the team, providing process development, project management, leadership, mentoring, and training within the Revenue Recovery department.
Expected to work as an integral member of the Revenue Recovery Management Team to identify, resolve, and apply close gap measures for all operational issues using defined processes, expertise and judgement
Oversight for multiple areas of responsibility within the Revenue Recovery department including:
Billing and recovery of claims overpayments
Investigating and pursuing recoveries and payables on Subrogation cases (Third Party Liability and Workers Comp)
Responsible for working with the team and setting up overpayment identifiers to monitor timely and accurate job tasks
Identify new recovery potential and develop plans to meet the short term objectives as needed by the department
Document and communicate outcomes of claims investigation to all applicable internal and external stakeholders to facilitate resolution of overpayments
Oversight of the design and implementation of system automation for the department
Monitor and reconcile billing and recovery data in applicable systems
Participate in management level meetings
Prepare and report the month-end financials for the Revenue Recovery department
Perform other 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.
Bachelor’s degree with 5+ years of experience working in Managed Health Care at a Payor / Healthplan or a group with Global Risk or 8+ years of experience in lieu of a degree)
3+ years of experience supervising or managing direct reports
1+ years of experience working in the following areas:
Healthplan and Provider Contracts (DOFRs, Compensation rates etc.)
Stop Loss Reinsurance
Experience interpreting and negotiating Managed Care Excess Loss Insurance Policy
Intermediate level of proficiency with Microsoft Excel
Access Database experience or working knowledge of SQL
You will be asked to perform this role in an office setting or other company location
Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained
Knowledge and experience in ICD-10 and HCPC coding
Experience working with high volume of claims data
Analytical and problem-solving skills
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity 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.
North American Medical Management, California, Inc. (NAMM) develops and manages clinician networks, offering a full range of services to assist physicians and other clinicians in their managed care and business operations. For over 17 years, NAMM has been an innovator in health care with a track record for quality, financial stability, extraordinary services and superior electronic capabilities. Prime Care Medical Network is a key affiliate.
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
Job Keywords: Revenue Recovery, Managed Care, Healthcare, Supervisor, Manager, claims audit, Subrogation, Stop Loss Reinsurance, Excel, Access, SQL, HCP-10, HCPC coding, Ontario, CA, California