Claims Supervisor- Springfield, MO
UnitedHealth Group - Springfield, MO

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Position Description:

Flexible, Friendly, Fast on your feet, That's a great start. Accurate, Accountable,Self Directed, These traits can take you places. Our claims operations are the focal point of handling information about services patients receive and they way those services get paid. It's complex, detailed work. It's fast paced challenge. It's a job that calls on you to be thoughtful, resourceful, team-driven and customer-focused. To put it mildly, there is never a dull moment.

Positions in this function are responsible for providing expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting claims. Authorizes the appropriate payment or refers claims to investigators for further review. Conducts data entry and re-work; analyzes and identifies trends and provides reports as necessary.

Primary Responsibilities:
  • Provide expertise and/or general claims support to teams in reviewing, researching, negotiating, processing and adjusting claims
  • Authorize appropriate payment or refer claims to investigators for further review
    Analyze and identify trends and provides reports as necessary
  • Consistently meet established productivity, schedule adherence, and quality standards
    Respond to claims appeals
  • Supervise, monitor, track and direct day to day operations to staff
  • Consistently meet established productivity, schedule adherence, and quality standards
  • Respond to claims appeals
  • Coordinates, supervises and is accountable for the daily activities of business support, technical or production team or unit.
  • Impact of work is most often at the team level.

Requirements:
  • High School Diploma/GED is required
  • 3+ years of previous claims processing experience; i.e. someone who has the ability to actual process claims
  • Knowledge of COMET and/or UNET; i.e. someone who is skills in high level review of claims making determinations regarding appeals and grievances
  • Intermediate level of proficiency with MS Word, Excel, and PowerPoint (Word – creating and editing Word documents; Excel – creating spreadsheets, tracking and trending, sorting/filtering, analytical analysis; PowerPoint – creating slide show presentations from scratch)

Assets:
  • 3+ years of coaching and/or team lead experience
  • Leadership experience is a strong plus

UnitedHealthcare, part of the UnitedHealth Group family of companies, is comprised of three specialized businesses dedicated to meeting the health care benefits needs of individuals and groups; all part of something greater, but each with a specialized focus:

UnitedHealthcare Employer & Individual works with individuals, small businesses and large multi-site employers to provide innovative, affordable benefits services.

UnitedHealthcare Medicare & Retirement is focused on serving Americans over the age of 50. It is the largest business dedicated to meeting the growing health and well-being needs of aging individuals in the nation, serving one in five Medicare beneficiaries through a comprehensive and diversified array of products and services through four industry-leading businesses.

UnitedHealthcare Community & State provides high-quality, personalized, public-sector health care programs that help local government agencies improve health outcomes for millions of children and low-income and disabled individuals at an affordable cost.

Together, we're removing the barriers that keep people from receiving the kind of quality health care that makes a difference. We focus on Integrity, Compassion, Relationships, Innovation and Performance as we empower people to achieve better health and well-being.

Come grow and thrive in our culture of innovation and ideas. Because there is no opportunity greater than the quest to help people live healthier lives.

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.

UnitedHealth Group - 17 months ago - save job - block
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