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.
Combine two of the fastest - growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you getLeading edge technology in an industry that`s improving the lives of millionsHere, innovation isn`t about another gadget, it`s about making healthcare data available wherever and whenever people need it, safely and reliablyThere`s no room for errorJoin us and start doing your life’s best workSm
The senior recovery / resolution analyst will work with a team on researching issues to determine feasibility of reducing medical costs through prospective solutions of claim system processes and claim business rules.
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:
Examine, assess, and document business operations and procedures to ensure data integrity, data security and process optimization.
Investigate, recover, and resolve all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities
Investigate and pursue recoveries and payables on subrogation claims and file management
Initiate phone calls to members, providers, and other insurance companies to gather coordination of benefits information
Process recovery on claims
Ensure adherence to state and federal compliance policies, reimbursement policies, and contract compliance
Use pertinent data and facts to identify and solve a range of problems within area of expertise
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)
Working knowledge of medical terminology and claim coding.
Knowledge of claims processing systems and guidelines/processes
Intermediate skills with microsoft excel (create, edit, sort, filter, pivot tables)
Experience in healthcare
Certified professional coder (cpc)
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:
Associate’s degree (or higher)
Coder certification (ccs, cic, coc, or cpma)
Registered nurse license
1+ years of project management experience
2+ years of medical record coding experience with experience in evaluation and management services in the inpatient setting.
1+ years of experience analyzing data and identify cost saving opportunities
Knowledge of medicaid/medicare reimbursement methodologies
2+ years of experience with claims auditing and researching claims information
Microsoft access (create, edit, format, manipulate data) intermediate skills with microsoft excel (create, edit, sort, filter, pivot tables)
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 optuminsightInformation and technology have amazing power to transform the healthcare industry and improve people`s livesThis is where it`s happeningThis is where you`ll help solve the problems that have never been solvedWe`re freeing information so it can be used safely and securely wherever it`s neededWe`re creating the very best ideas that can most easily be put into action to help our clients improve the quality of care and lower costs for millionsThis is where the best and the brightest work together to make positive change a realityThis is the place to do your life’s best workSm
Colorado residents only: the hourly range for colorado residents is $25.63 to $45.72Pay 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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