Job details
Job type full-time
Full job description
You’ll enjoy the flexibility to telecommute* from anywhere within the u.sAs you take on some tough challenges.
Get the training you need to build the success you wantClasses starting soon, so apply today!
Welcome to one of the toughest and most fulfilling ways to help people, including yourselfWe offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancementJoin us and start doing your life`s best work Sm
As a claims representative , you will play a critical role in creating a quality experience that impacts the financial well-being of our membersYou will be the expert problem solver as you work to quickly identify, analyze and resolve issues in a fast-paced environmentThis is your chance to take your career to the next level as you support teams by reviewing, investigating, and processing claimsBring your listening skills, emotional strength and attention to detail as you work to ensure every claim has a fair and thorough review
This position is full-time (40 hours/week) monday – friday; 8:30 – 5pm cstIt may be necessary, given the business need, to work occasional overtime or weekends.
*all telecommuters will be required to adhere to unitedhealth group’s telecommuter policy.
Primary responsibilities:
Initiate telephone calls to members, providers and other insurance companies to gather coordination of benefits data
Verify/validate applicable systems to reflect updated cob information and ensure that future payments are processed correctly
Ensure that the proper benefits are applied to each claim by using the appropriate processes and procedures (e.gClaims processing policies and procedures, grievance procedures, cms/medicare guidelines, benefit plan documents
Complete on a daily basis all data entry required to document and communicate the status of claims as needed adhering to all reporting requirements
Communicate and collaborate with members and providers to resolve claims errors/issues, using clear, simple language to ensure understanding
Learn and leverages new systems and training resources to help apply claims processes/procedures appropriately (e.gOn-line training classes, coaches/mentors)
Meet the performance goals established for the position in the areas of: productivity, quality, member satisfaction and attendance
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 a related environment (i.eOffice, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools
Familiarity with computer and windows pc applications, which includes the ability to learn new and complex computer system applications
Preferred qualifications:
Previous experience with medical claims processing
Knowledge of medical terminology
Knowledge of cms/medicare/medicaid
Familiar with small group or self-funded product designs
Understanding of uhops processing system
Full covid-19 vaccination is an essential requirement of this roleUnitedhealth 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.
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
Unitedhealth group requires all new hires and employees to report their covid-19 vaccination status.
Military & veterans find your next mission: we know your background and experience is different and we like thatUnitedhealth group values the skills, experience and dedication that serving in the military demandsIn fact, many of the values defined in the service mirror what the unitedhealth group culture holds true: integrity, compassion, relationships, innovation and performanceWhether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journeyLearn more at https://uhg.hr/transitioning-military
Learn how teresa, a senior quality analyst, works with military veterans and ensures they receive the best benefits and experience possibleHttps://uhg.hr/vet
Careers with unitedhealthcareLet`s talk about opportunityStart with a fortune 5 organization that`s serving more than 85 million people already and building the industry`s singular reputation for bold ideas and impeccable executionNow, add your energy, your passion for excellence, your near-obsession with driving change for the betterGet the picture? unitedhealthcare is serving employers and individuals, states and communities, military families and veterans where ever they`re found across the globeWe bring them the resources of an industry leader and a commitment to improve their lives that`s second to noneThis is no small opportunityIt`s where you can do your life`s best workSm
Diversity creates a healthier atmosphere: unitedhealth group is an equal employment opportunity/affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
Unitedhealth group is a drug-free workplaceCandidates are required to pass a drug test before beginning employment.
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