Employer: UnitedHealth Group
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
The health care system is still evolving at a rapid pace. Technology is driving new advances in how patient care is delivered and how it’s reimbursed. Now, UnitedHealth Group invites you to help us build a more accurate and precise approach to claims adjudication. In this role, you’ll be responsible for reviewing and making adjustments or corrections to processed claims through researching, investigating issues, making a determination and then communicating as required. Using multiple platforms, you’ll also assist with pricing verification, prior authorizations, benefits and coding. Join us and build your career with an industry leader.
This position is full-time (40 hours/week) Monday – Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of (7:00am – 3:30pm). It may be necessary, given the business need, to work occasional overtime.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Primary Responsibilities:
- Update claim information based on research and project instructions and submitter documentation.
- Complete necessary adjustments to claims and ensure the proper benefits are applied to each claim by using the appropriate processes and procedures (e.g. claims processing policies and standard operating procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/certificates)
- Communicate extensively with internal business partners and health plan representatives regarding adjustments to resolve claims errors/issues, using clear, simple language to ensure understanding
- Learn and leverage new systems and training resources to help apply claims processes/procedures
- Ability to successfully operate in a fast-paced production environment while remaining quality-focused and adaptable to changes and innovations
- Results-focused and able to work to metric goals and project deadlines (e.g. department guaranteed turn-around-times, etc.)
- Ability to multi-task and move between shifting priorities, make data-driven decisions based on analysis of trends and understanding of results urgency
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 (or higher) OR equivalent years of work experience
- 1+ years of experience in a related environment (i.e. office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools
- Demonstrated ability in using computer and Windows PC applications, which includes strong keyboard and navigation skills and learning new computer programs
Soft Skills:
- High-level written and verbal professional communication skills
- Ability to work as a member of a team, build strong working relationships at all department levels, and coordinate with others to resolve issues in a timely manner
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
