Role Description The Billing and Payment Research Specialist is responsible for processing, auditing, and submitting primary and secondary insurance claims, ensuring accuracy, compliance, and timely reimbursement. This role utilizes electronic claims management systems to review, correct, and resolve billing errors, denials, and rejections. The Billing Specialist I collaborates with internal teams, facility liaisons, and payers to ensure clean claim submission and adherence to federal, state, and payer-specific regulations. - Processes and submits primary and secondary insurance claims accurately and in a timely manner, ensuring compliance with payer guidelines and regulatory requirements. - Reviews and resolves claim errors, rejections, and denials, making necessary corrections and resubmitting claims as needed. - Demonstrates working knowledge of billing forms, including UB-04, CMS-1500, or state-specific billing forms, ensuring claims are submitted with the appropriate documentation. - Audits claims for accuracy, checking for duplicate charges, overlapped accounts, and missing information before submission. - Conducts payment research with insurance payers via phone, meeting required metrics and KPI's. - Investigates and processes rebill requests, verifying claim accuracy and making necessary updates per facility or coding liaison direction. - Maintains knowledge of billing regulations, payer policies, and electronic submission guidelines, staying up to date with federal, state, and local billing requirements. - Utilizes electronic billing systems to analyze, research, and transmit claims, ensuring proper documentation of actions taken in the collection system. - Monitors and reports charging or edit trends, collaborating with internal teams (such as coding, patient access, and ancillary departments) to improve billing accuracy. - Performs daily balancing tasks using SSI and other billing systems, escalating unresolved issues or billing delays to the Billing Services Manager. - Communicates professionally with payers, facility representatives, and internal teams, ensuring efficient issue resolution and proper follow-up on outstanding claims. - Performs other duties as assigned. - Maintains regular and reliable attendance. - Complies with all policies and standards. Qualifications - H.S. Diploma or GED required - Associate Degree in Business, Healthcare Administration, Medical Billing, or a related field preferred - 0-1 years of experience in medical billing, insurance claims processing, or revenue cycle operations required - 1-3 years of billing experience in a medical facility, ambulatory surgery facility, or acute-care preferred - Experience with hospital or physician billing, including knowledge of payer policies and electronic claims systems preferred Requirements - Basic understanding of insurance claim processing, medical billing, and reimbursement guidelines. - Familiarity with billing software, electronic claims management systems (e.g., SSI, Pulse/DAR), and eligibility tools. - Knowledge of CMS, Medicaid, Medicare, and commercial insurance billing regulations. - Ability to analyze and resolve claim errors, denials, and rejections efficiently. - Strong attention to detail, organizational skills, and ability to meet deadlines. - Proficiency in Microsoft Office Suite (Excel, Outlook, Word) and electronic health record (EHR) systems. - Excellent communication and problem-solving skills, with the ability to interact professionally with internal teams and external payers. Benefits - Comprehensive Health Coverage: Medical, dental, and vision plans to keep you and your family healthy. - Competitive Pay & Full Benefits: A salary and package designed to reward your expertise and dedication. - Paid time off - Flexible scheduling - Future Security: 401(k) with matching.

Requisition Number: 2357641 Optum NY/NJ, is seeking a Health and Safety Specialist to join our team in Newark, NJ. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone. At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together. The Health and Safety Specialist plays a critical role in supporting organizational environmental, occupational health, and safety initiatives. This position ensures compliance with applicable regulations, promotes a safe workplace culture, and provides direct support to staff and leadership across all sites. The Specialist will be responsible for developing and implementing safety programs, conducting inspections, investigating incidents, and providing education and training to employees. This role will primarily support New Jersey sites, with regional program ownership and analytics. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. Primary Responsibilities: - Serve as a resource for safety-related inquiries, providing timely and accurate guidance - Respond to employee concerns, phone calls, and emails in a professional and supportive manner - Assist leadership and staff during emergencies, including chemical spills, workplace injuries, or security threats - Support compliance with OSHA, EPA, and other regulatory requirements - Conduct inspections, audits, and assessments to identify risks and recommend corrective actions - Investigate incidents and occupational health events, documenting findings and corrective actions - Manage compliance reporting, recordkeeping, and follow-up activities - Assist in the development, review, and implementation of safety policies, procedures, and training programs - Support safety program integration at new or relocated sites, ensuring compliance from the outset - Coordinate vendor relationships related to waste management and other compliance services - Deliver safety training for staff for annual refreshers, and specialized sessions - Develop and update educational resources to promote safety awareness and best practices - Actively participate in safety committees, workgroups, and organizational initiatives - Respond to environmental and occupational health events such as spills, facility hazards, or regulatory inquiries - Lead and manage EOHS-related projects across the region, ensuring timely execution, stakeholder alignment, and compliance with organizational and regulatory standards - Develop, analyze, and maintain EOHS data and reporting, including trend analysis, dashboard development, and data reconciliation across systems (eg, RLDatix, Sedgwick, training platforms) - Monitor and report on key EOHS metrics such as training compliance, occupational health titers, and workplace injury/illness data (BLS), supporting data-driven decision-making 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: - Experience managing multiple projects and deadlines independently - Experience in incident investigation, audits, or compliance monitoring - Knowledge of OSHA regulations and general workplace safety standard - Reliable transportation and ability to travel to site in New Jersey and New York on a regular basis Preferred Qualifications: - Professional certification (eg, OSHA 30, CHSP, CSP, CIH, or similar) - 2+ years of experience in occupational health and safety or environmental compliance - Experience with safety management systems or reporting platforms - Knowledge of waste management regulations and vendor coordination *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable. 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. 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. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Role Description The Payer Reimbursement Specialist is responsible for performing advanced Level 2 audits of payer contract loads, ensuring accuracy, compliance, and proper documentation across all centers. This role serves as a highly skilled technical resource, reviewing contract load accuracy. This position requires a seasoned A/R or reimbursement professional with strong managed care knowledge, exceptional organization, and the ability to work in a fast-moving, evolving environment. - Perform SOX Level 2 audits to validate contract load accuracy. - Review contract rate loads, contract types, MPRs, insurance carrier links, and contract grid updates. - Identify and document discrepancies, coordinate corrections with Managed Care Finance Ops. - Identify where contract grid updates are needed to communicate updates to payer reimbursement analysts, adding notes and ensuring accurate documentation for all audits. - Utilize and maintain tracking systems; monitor audit status and follow-up needs. - Assist in implementing improved tracking and workflow processes, including potential ticketing and intake solutions. - Communicate regularly with Analysts, Managers, and contract loaders to resolve audit findings. - Support special projects and other reimbursement initiatives. - Additional responsibilities assigned as needed. Qualifications - Strong managed care knowledge. - Exceptional organization skills. - Ability to work in a fast-moving, evolving environment. Requirements - Seasoned A/R or reimbursement professional. Company Description

• Submit clean, timely claims with accurate CPT, HCPCS, ICD-10 codes, and modifiers. • Track and resolve denials, rejections, and underpayments with appropriate follow-up and resubmission. • Validate eligibility, authorization, and proper billing pathways for all patient encounters. • Ensure accurate use of telehealth, SDOH, and preventive care codes. • Coordinate with credentialing, partner success, and payer reps to ensure claims compliance. • Perform other duties as assigned. • Review provider documentation and assign accurate codes per ICD-10-CM, CPT, and HEDIS/quality reporting guidelines. • Identify and escalate incomplete documentation or coding gaps; issue coding queries as needed. • Educate providers under the guidance of the Coding Manager to drive documentation improvement. • Support implementation and testing of new documentation macros and encounter note templates. • Maintain and contribute to the internal billing rules matrix (payer, state, provider type, modifiers). • Collaborate with the Data & Analytics team to track claim trends, documentation compliance, and A/R performance. • Partner with Revenue Cycle and Clinical Ops to align workflows with payer requirements and business goals. • Support provider training, macro updates, and compliance education efforts.