Employer: UnitedHealth Group
The Claims Clerk is responsible for providing expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting claims.
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 8:00am – 5:00pm CST. It may be necessary, given the business need, to work occasional overtime. Our office is located at 300 Burnett Street, Suite 200 Fort Worth, TX 76102.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Primary Responsibilities:
- Provide general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims.
- Authorize the appropriate payment or refers claims to investigators for further review.
- Conduct data entry and re-work; analyzes and identifies trends and provides reports as necessary.
- Analyze and identify trends and provide reports as necessary
- Consistently meet established productivity, schedule adherence, and quality standards
- Recognize claims by determining claim type – HCFA, Hospital, UB, and/or RX
- Identify more complicated claims and refer them to Senior Claim Processor or Supervisor
- Calculate other insurance and re-pricing benefits
- Work claims files to ensure the appropriate eligibility and provider records are matched to the claim
- Updates and maintains claims tracking database
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)
- 1+ years of experience in an office setting environment using the telephone and computer as the primary instruments to perform job duties
- 2+ years of data entry experience
- Experience with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
- Basic understanding of healthcare claims including ICD-9 and CPT codes
- If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders
- Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance.
Preferred Qualifications:
- 1+ years of experience working with medical claims
- 1+ years of working in production based environment
- Type 60+ WPM
- Prior experience working with IDX software
Soft Skills:
- Ability to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each product