Collections Representative (Accounts Receivable) – Optum
Location: Chennai, Tamil Nadu, India
Job Category: Billing
Requisition Number: 2323686
Optum, a global leader in technology-enabled healthcare solutions, is seeking a skilled Collections Representative to support its revenue cycle operations. This role directly contributes to improved health outcomes by ensuring accurate, efficient, and compliant claims management. Join a team driven by innovation, inclusion, and growth, and be part of a global mission to advance healthcare optimization.
Position Overview
The Collections Representative (AR Associate) is responsible for managing all Accounts Receivable functions within the client-focused revenue cycle process. The role requires comprehensive knowledge of standard operating procedures (SOPs), strong analytical abilities, and effective communication to identify issues, highlight trends, and drive process improvements.
Key Responsibilities
Review and analyze outstanding insurance balances to resolve issues delaying claim payment, working closely with payers, clients, and patients.
Identify denial trends and recommend corrective actions to improve first-pass resolution rates and reduce AR aging.
Demonstrate working knowledge of the complete accounting and claim life cycle in healthcare revenue operations.
Ensure timely completion of all workflow items within defined turnaround times and quality standards.
Analyze Explanation of Benefits (EOBs) and denials at the claim level to identify trends affecting financial performance.
Perform assigned tasks in alignment with process guidelines, quality standards, and operational requirements.
Comply with employment terms, organizational policies, and directives, including potential changes in responsibilities, work location, shifts, or workflows.
Required Qualifications and Experience
Graduate degree (any discipline).
Minimum 1.5 years of experience in Healthcare Accounts Receivable, specifically in Denial Management.
Strong understanding of HIPAA rules, privacy laws, access, and release of information standards.
Solid knowledge of medical insurance including HMO, PPO, Medicare, Medicaid, and private payer policies.
Proficiency in necessary workflow applications and tools.
Strong skills in MS Office, especially Excel and Outlook.
Excellent communication abilities for both internal and external stakeholders.
Strong judgement, critical thinking, and problem-solving skills.
Proven ability to maintain accuracy, professionalism, and client-focused service standards.
Efficient typing and keyboard skills with a high level of reliability.
Gujarat :
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