Job details
Job type full-time
Full job description
If you are located in green bay, wi, you will have the flexibility to telecommute* (work from home) as 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 health care system is still evolving at a rapid paceTechnology is driving new advances in how patient care is delivered and how it’s reimbursedNow, unitedhealth group invites you to help us build a more accurate and precise approach to claims adjudicationAs part of our recovery and resolutions team, you’ll provide consultative support to our business units and external vendor organizationsYou’ll handle requests, define business requirements and coordinate resolutions incorporating state and federal regulationsJoin us and build your career with an industry leader.
Training will be conducted virtually from your homeThis position is full-time (40 hours/week) monday - friday during our normal business hours of 8:00am - 4:30pmIt 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:
Define and document/communicate business requirements
Analyze scope and resolution of medium to large size operations management (om) and development requests
Serve as a key resource on complex and/or critical issues and help develop innovative solutions
Perform complex conceptual analyses
Serve as a key resource on complex and/or critical issues and help develop innovative solutions
This is a challenging role with serious impactYou’ll be assisting, educating, problem-solving and resolving challenging situations to the best possible outcomesYou’ll need to understand and interpret clients’ needs and ensure service and delivery excellence supporting the fraud, waste, abuse, and error product suiteThis involves working with a high complexity solution set and cross functional teams to proactively review, research and resolve highly escalated inquiries.
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 problems
2+ years of experience with claims auditing, researching claims information, or payment integrity (experience healthcare billing, coding, claims, auditing, reimbursement, or data)
2+ years of experience using any claims platforms such as unet, pulse, nice, facets, diamond, etc.
Proficiency using microsoft excel (data entry, sorting/filtering, pivot tables, v-lookups)
Telecommuting requirements:
Must live within 50 miles from green bay, wi
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) or high school diploma / ged (or higher) and 2+ years in a sme position
Understanding of medical coding methodologies
1+ years of experience in health care claims recovery
Proficiency using microsoft powerpoint (create and edit presentations)
Basic ability to read/review sql
Previous experience with medicare/medicaid payments
Soft skills:
Ability to produce within a fast paced, matrixed organization with limited direction
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
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.
Keywords: healthcare, health care, managed care, claims, customer service, claims recovery, work at home, work from home, wah, wfh, remote, telecommute, hiring immediately, #rpo
