Credit Resolution Representative - Brewer, ME
Company: Optum
Location: Brewer
Posted on: May 12, 2025
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Job Description:
Opportunities at Northern Light Health, in strategic partnership
with Optum. Whether you are looking for a role in a clinical
setting or supporting those who provide care, we have opportunities
for you to make a difference in the lives of those we serve. As a
statewide health care system in Maine, we work to personalize and
streamline health care for our communities. If the place for you is
at a large medical center, a rural community practice or home care,
you will find it here. Join our compassionate culture, enjoy
meaningful benefits, and discover the meaning behind: Caring.
Connecting. Growing together.
This role handles information about patient services and how those
services are paid by investigating and resolving credit balances
through contact with various parties. - The intermediate-level
Credit Resolution Representative is responsible for the overall
management of an assigned provider client's credit balance
inventory and may manage multiple inventory types at any given
time. The Credit Resolution Representative will analyze, research,
and recommend/take appropriate steps to resolve the credit balance
account. Accounts resulting in an overpayment will be monitored by
the Credit Resolution Representative through to resolution.
Additionally, the Credit Resolution Representative is responsible
for the communication with their day-to-day contacts, answering all
questions and inquiries that may generate from recommendations made
or individual accounts that need addressed quickly. - The Credit
Resolution Representative will also participate in the
weekly/monthly/quarterly presentations with their supervisor or
management, regarding credit balance reduction, and recommended
actions to keep credit balances within overall required volumes,
dollars and age. The Credit Resolution Representative will work
closely with their credit balance teammates, areas within the
Patient Financial Department, and Leaders to continually improve
upon credit resolution timeliness, credit root-cause solutions and
operational best practices.
This position is full time -Monday - Friday. Employees are required
to have flexibility to work any of our 8-hour shift schedules
during our normal business hours of 8:00am - 4:30pm. Employees are
required to work 2 days onsite and 3 days from home.
We offer 4 weeks of on-the-job training. The hours of the training
will be aligned with your schedule.
If you are within commutable distance to the office at 43 Whiting
Hill Rd., Brewer, ME 04412, you will have the flexibility to work
from home and the office in this hybrid role* as you take on some
tough challenges.
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Primary Responsibilities: -
Provide expertise by reviewing, researching, and resolving all
types of accounts in a credit balance to bring final resolution and
root cause analysis for health plans, commercial clients and
government entities
Fundamental Execution
Plan, prioritize, organize and complete work to meet established
production goals required by provider clients, as well as Optum
goals, quotas and deadlines in a fast pace and ever-changing
environment
Provide top quality by researching accounts fully, reviewing and
adhering to payer, provider & Optum quality requirements
Ensure adherence to state and federal compliance policies,
reimbursement policies and contract compliance
Inventory Management
Credit Balance follow up and resolution, ensuring required
compliance account timeliness guidelines are met within 30/60/180
days. Follow up includes researching why inventory is outstanding
and working with Optum management and provider client to ensure
resolution
Manage multiple different inventory work queues and workflows,
including multiple payer and provider client referred credit
inventory, as well as unsolicited/correspondence inventory
Reporting & Analysis
Analyze and identify trends and provide reporting as necessary to
provider clients, management
Utilize various workflow applications and reports to manage
inventory, follow up as needed & drive client relationships
Work independently with little direct onsite supervision
Build relationships with day-to-day contacts at assigned provider;
Accounting, customer service, Accounts Receivable, contracting,
business support teams, etc.
Collaborate with peers assigned to provider client to make sure
best in class principles are applied to all credit balance
reduction approaches
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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/GED
Must be 18 years OR older
1+ years of experience in patient access/registration, patient A/R
& billing, accounts payable reconciliation or cash posting
Experience with Microsoft Word (create correspondence and work
within templates), -Microsoft Excel (data entry, sort / filter, and
work within tables) and Microsoft Outlook (email and calendar
management)
Ability to work a hybrid schedule, with onsite presence up to two
days per week at 43 Whiting Hill Road, Brewer, ME 04412
Ability to work Monday - Friday, 08:00AM - 04:30PM
Full Flu vaccination are an essential job function of this role.
Candidates located in states that mandate Flu booster doses must
also comply with those state requirements. UnitedHealth Group will
adhere to all federal, state and local regulations as well as all
client requirements and will obtain necessary proof of vaccination,
and boosters when applicable, prior to employment to ensure
compliance. Candidates must be able to perform all essential job
functions with or without reasonable accommodation
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Preferred Qualifications: -
2+ years of experience in claims recovery and resolution for an
operations-based environment
2+ years of customer service experience
Experience with payment variance resolutions
Healthcare finance experience with a focus in auditing and/or
analysis
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Telecommuting Requirements:
Reside within commutable distance to the office at 43 Whiting Hill
Rd., Brewer, ME 04412
Ability to keep all company sensitive documents secure (if
applicable)
Required to have a dedicated work area established that is
separated from other living areas and provides information
privacy
Must live in a location that can receive a UnitedHealth Group
approved high-speed internet connection or leverage an existing
high-speed internet service
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Soft Skills:
Proven solid Communication and Customer Service skills
Proven exceptional organizational/time management skills
Demonstrated ability to work in a dynamic environment both
independently and in a group setting
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*All employees working remotely will be required to adhere to
UnitedHealth Group's Telecommuter Policy.
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The hourly range for this role is -$16.88 to $33.22 per hour based
on full-time employment. 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.
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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.
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UnitedHealth Group is an Equal Employment Opportunity employer
under applicable law and qualified applicants will receive
consideration for employment without regard to race, national
origin, religion, age, color, sex, sexual orientation, gender
identity, disability, or protected veteran status, or any other
characteristic protected by local, state, or federal laws, rules,
or regulations.
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UnitedHealth Group is a drug - free workplace. Candidates are
required to pass a drug test before beginning employment.
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#RPO #RED #RPOLinkedIn
Keywords: Optum, New England , Credit Resolution Representative - Brewer, ME, Other , Brewer, Northeast
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