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.
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 workSm
Flexible, friendly, fast on your feet, that`s a great startAccurate, accountable, self-directed; these traits can take you placesOur claims operations are the focal point of handling information about services patients receive and they way those services get paidIt`s complex, detailed workIt`s fast paced challengeIt`s a job that calls on you to be thoughtful, resourceful, team-driven and customer-focusedTo put it mildly, there is never a dull momentIsg prevention specialist are responsible for investigating and remediating claim issues that have been presented by providers that have failed the service model.
Training will be conducted virtually from your homeThis position is full-time (40 hours/week) monday - fridayEmployees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am – 5:00pmIt 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:
Perform deep dive analyses to identify root cause failures and develop remediation action plans for escalated provider issues
Collaborate with business partners to resolve issues impacting providers
Act as the point of contact for escalated provider issues, providing end to end provider service, including incident identification and understanding, and following up with remediating action plans
Collaborate with internal and external business partners to resolve and close out escalated provider issues, communicating the final resolution actions back to the provider
Collaborate with internal and external business partners to identify innovative solutions for resolving escalated provider issues and to decrease the overall number of escalated provider issues in each market
Track and monitor multiple ongoing projects for status and resolution
Engage in predictive analytics to prevent system and other claim related issues from impacting providers
Build trust with providers by communicating issue resolution progress from start to finish, and by providing updates on resolution plans and implementation schedules
Ensure end to end provider service satisfaction for a variety of service issues across all lines of business at uhg
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)
2+ years of experience analyzing and solving customer problems in an office setting environment
3+ years in a technical or metrics based environment; preferably claims and/or customer service
1+ years of experience with issue resolution, claims, and / or provider and network service operations (i.eClaim payments / adjustments, appeals, sop adherence, customer service or service related fields
1+ years of experience with either unet or cosmos to perform searches and claim look-ups.
Experience with microsoft excel (creating spreadsheets and formulas), microsoft word (creating documents) and microsoft outlook (drafting emails, calendar management)
Ability to work an 8 hour shift schedules during core normal business hours
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:
Bachelor’s degree (or higher)
Experience with business or data analysis: collecting, analyzing, and presenting data and recommendations to management
Experience with provider practices, billings and revenue cycles
Experience working with process improvements, workflows, benchmarking and / or evaluation of business processes
Experience with hospital or physician claim processing
Experience speaking with providers for issue resolution
Soft skills:
Ability to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each product
Excellent communication and time management skills
Problem solving, critical thinking, organizational and analytical skills
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 wherever 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
Colorado residents only: the hourly range for colorado residents is $20.77 to $36.88Pay is based on several factors including but not limited to education, work experience, certifications, etcAs of the date of this posting, in addition to your salary, uhg offers the following benefits for this position, subject to applicable eligibility requirements: health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; employee assistance program; pto; and employee-paid critical illness and accident insurance.
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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