Financial Assistant - Des Moines, IA
This position is responsible for recording, and tracking the recovery of, Medicaid Program overpayments discovered during reviews of the billing and utilization patterns of health care providers. The person prepares monthly, quarterly, and annual reports detailing recovery activity and maintains databases that store the required data.
The position is responsible for preparing and tracking necessary claim credits and adjustments within the customer's automated payment system in order to recover overpayments against future claims activity. The person is also responsible for using overpayment and recovery data to assist in analyzing the overall effects of payment recoveries on state Medicaid payments and funding. The person will also conduct research on historical payments and recoveries in order to satisfy requests for information and to comply with regular federal and state audits.
This position may assist in the identification of potentially aberrant billing practices and make appropriate recommendations where requested.
The person updates databases timely and accurately based on ongoing review work, special projects, and resulting recoveries. Coordinates with review staff and/or other IME contractors regarding activities that affect recoveries, if necessary. Recommends database enhancements for increased efficiency of PI recovery activities and coordination.
Maintains a high level of expertise in the use of desktop applications and electronic data analysis to execute job functions. Utilizes MS Word, Excel, and Access for accurate and efficient completion of job assignments. Accesses the Internet and uses software on CD-ROM effectively for research. May be asked to review and analyze large amounts of electronic claims data.
Works under the supervision of the Operations Manager. Must be able to complete all job tasks with minimal supervision. Regularly works with confidential information of major importance. Must therefore understand importance of keeping data confidential (i.e.: HIPAA requirements). Inappropriate disclosure may result in termination.
Standard office working conditions with negligible amount of travel. Responsibilities of the position demand the ability to work under pressure.
Must be able to create and maintain an environment which promotes quality work within reasonable timeframes.
- High School Diploma/GED with 2+ years of equivalent work experience OR an Associate Degree in Finance/Accounting required. Bachelor's degree desirable.
- 1+ year previous Health Insurance experience preferred.
- 1+ year of Medicaid or Medicare program experience preferred.
- Requires competence in use of standard office software programs, including MS Word and Excel and ability to use the Internet for research.
- Data collection, pattern analysis, and trending desirable but not required.
- HIPAA knowledge highly preferred.
- Knowledge of medical billing systems highly preferred but not required
- Must be able to work and multi-task in fast-paced environment and be a careful and accurate worker who pays close attention to detail.
OptumInsight is one of the largest and fastest growing health information companies. We specialize in improving the performance of the health system by providing analytics, technology and consulting services that enable better decisions and results. We integrate workflow solutions that deliver data in real-time, and create actionable insights - processing health information that relates directly to and affects one in four patients in the U.S, one in every three Medicaid dollars and one in every five emergency room visits. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation Performance.
What can YOU do with the right information? At OptumInsight, the possibilities and the impact are limitless. No matter what your role is at OptumInsight, you'll be empowered to ask more questions, develop better solutions and help make the health care system greater than ever. It's always fresh. It's always exciting. And it's never been more important.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.