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“Optum” Company Details
| Company Name | Optum |
| Rating | 3.1 / 5.0 |
| Job Type | Full-time |
| Job Position | Remote Position |
Senior Account Payable Processor – National Remote Job Overview
The Rebate Specialist 3 works independently under general supervision and relies on instructions and pre-established guidelines to perform the functions of the…
What to do in Optum company Job
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
The position and grade level are underwritten by the contract Optum has with the State of Utah to perform rebate administration duties for Utah Medicaid’s FFS population. Utah Medicaid also recently awarded OptumRx a renewal of services, including rebate administration.
The Rebate Specialist 3 works independently under general supervision and relies on instructions and pre-established guidelines to perform the functions of the job. They are responsible for managing some of the more complex manufacturer accounts like CSL BEHRING and Genentech, they perform account reviews on assigned caseload, conduct manufacturer correspondence using established standard responses, and perform advanced system testing as needed.
They lead programs for the quarterly invoicing conducting QA and mailing the invoices to drug manufacturers. They assist with HCPCS/ NDC edit derivation & POS edit creation which requires an in depth understanding of the Unit of Measure (UOM) differences between Medispan and CMS, as well as the ability to calculate conversion factors based off a HCPC description and CMS unit of measure.
You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
- Assist with Training of new staff when needed
- Other duties include Caseload Account Management – Research and analysis of a set of most complex assigned drug manufacturer accounts, identify pharmacy and medical claim billing errors
- Create and send various communications to drug manufacturers and company supervisors for disputed invoices, including historical claim utilization disputes, to reach final resolution and reconciliation using established standard responses
- Invoice Management – Lead quality assurance testing on all Federal, Managed Care, and Supplemental rebate claims and invoices, and understands the challenges associated with each type
- Performs intricate and detailed adjustments to claims as verified by providers and state official
- Provides administrative and analytical support for special projects and assists with state and federal audits as required
- Involved in testing of new applications and system version releases
- Assists with review, documentation, and formalization of Standard Operating Procedures
- Assists in preparation of quarterly reports as required by state government
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:
- High school diploma or GED
- 3+ years experience in a retail pharmacy, physician office or hospital setting
- Experience in caseload management and dispute resolution documentation, tracking and reporting
- Proven solid math, accounting, problem solving and decision-making abilities
- Proven excellent written and oral communication skills
- Demonstrated proficiency in Microsoft Word and Excel Programs
Preferred Qualifications:
- Some college education
- Certified Pharmacy Technician license
- Proven excellent customer service skills for both internal and external clients
- Proven knowledge of medical claims billing using a HCFA 1500 and UB-04 billing form helpful
- All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The hourly range for this role is $19.47 to $38.08 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
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: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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.
UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.
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