You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
At UnitedHealthcare , we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life’s best work. SM
The health care system is evolving at a rapid pace. Technology is driving new advances in how patient care is delivered and reimbursed. Now, E&I Claim Performance and Rework Operations of UnitedHealth Group invites you to help us execute a more accurate and innovative approach to claims resolution. This is a very challenging role with serious impact. You'll be providing a high level of support and subject matter expertise within a fast paced, intense, and high-volume claims operation where accuracy and quality are essential. Using multiple platforms, you’ll also assist with pricing verification, prior authorizations, benefits, and coding. If your mission is to have a direct positive impact on the customer, join us and build your career with an industry leader.
This position is full-time (40 hours/week) Monday - Friday. Employees are required to work any of our 8-hour shift schedules during our normal business hours with 6:00am – 6:00pm local time zone. It may be necessary, given the business need, to work occasional overtime.
$ads={1}
We offer 11 weeks of training. The hours during training will be 8:00am to 4:30pm EST.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Primary Responsibilities:
- Evaluate claim information based on research and communication from member or provider
- Complete necessary adjustments to claims and ensure the proper benefits are applied to each claim by using the appropriate processes and procedures (e.g., claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/certificates)
- Learn and leverage new systems and training resources to help apply claims processes/procedures
- Expert system navigation and computer skills
- Analyze trends and complete daily reports
- Provide expertise and complex claims support to customers
- Make determinations to authorize payment or refer claims to internal business partners for further review
- Apply an extensive understanding of claim intake and workflow
- Recall and leverage claim patterns, standards, and procedures to make determinations across a variety of claim scenarios
- Work independently
- Engage with customers as needed (i.e., phones, meetings, etc.) to resolve claims and communicate outcomes
- Thrive in an environment of intense innovation and change
- Act as a resource for others
- Meet performance metrics as defined by manager
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) OR equivalent work experience
- 2+ years of successful experience in a production environment, with computers as a primary job tool
- Experience with computer and Windows PC applications, including expert keyboard and navigation skills, multiple monitors, macros, and interface applications
- Ability to work any 8-hour shift schedules during our normal business hours with 6:00am – 6:00pm local time zone
Preferred Qualifications:
- UNET platform claim experience
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
- Ability to connect directly into internet - via hard wire (either directly to modem or router)
Careers with UnitedHealthcare. Work with a Fortune 5 organization that’s serving millions of people as we transform health care with bold ideas. Bring your energy for driving change for the better. Help us improve health access and outcomes for everyone, as we work to advance health equity, connecting people with the care they need to feel their best. As an industry leader, our commitment to improving lives is second to none.
California, Colorado, Connecticut, Nevada, New Jersey, New York, Washington or Rhode Island Residents Only: The salary range for California / Colorado / Connecticut / Nevada / New Jersey / New York / Washington / Rhode Island residents is $16.00 - $31.44. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.
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 workplace. Candidates are required to pass a drug test before beginning employment.
#RPO #YELLOW
