UnitedHealth Group
This position is full-time (40 hours/week) Monday to Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 06:30am 04:00pm. It may be necessary, given the business need, to work occasional weekends and overtime.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Primary Responsibilities:
- Analyzes and applies denials to third party carriers in all media types.
- Complies with departmental Business Rules and Standard Operating Procedures
- Focuses efforts on decreasing the Accounts Receivable, increasing cash, and/or reducing bad debt.
- Interprets explanation of benefits for appropriate follow up action.
- Utilizes automation tools to verify eligibility, claim status and/or to obtain better billing information.
- Creates worklist through Access database and manipulate data to analyze for trends and resolve claims for adjudication.
- Reviews and researches denied claims by navigating multiple computer systems and platforms, in order to accurately capture data/information for processing.
- Communicates and collaborates with members or providers to evaluate claims errors/issues, using clear, simple language to ensure understanding.
- Conducts data entry and re-work for adjudication of claims.
- Works on various other projects as needed.
- Meets the performance goals established for the position in the areas of: efficiency, accuracy, quality, patient and client satisfaction and attendance.
Required Qualifications:
- High School Diploma / GED (or higher) OR equivalent work experience
- 1+ years of experience in A/R, Billing, and Customer Service, Insurance, or Healthcare.
- Demonstrated ability using computer and Windows PC applications, such as Microsoft Outlook (setting calendar appointments, email) and Microsoft Excel (creating spreadsheets, filtering, navigating reports) instant message, video conferencing.
Telecommuting Requirements:
- Required to have a dedicated work area established that is separated from other living areas and provides information privacy
- Ability to keep all company sensitive documents secure (if applicable)
- Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
Preferred Qualifications:
- Some College level classes/coursework
- Medical terminology acumen and experience
- Must reside within a commutable distance from Quest office and be able to go into the office as needed for training, meetings, etc., depending on business needs