Position Description: You'll join a high caliber team where you're assisting, educating, problem-solving and resolving tenuous situations to the best possible outcomes. Bring your people skills, emotional strength and attention to detail. In return we offer the latest tools and most intensive training program in the industry. Get ready to start doing your life's best work.
Process recovery on claims. Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance. May conduct contestable investigations to review medical history. May monitor large claims including transplant cases.
Primary Responsibilities: Reviews the work of others.Develops innovative approaches.Sought out as expert.Serves as a leader/ mentor.
High School diploma/GED1+ year with the ability to review contracts between payer and providers to determine opportunity for cost savings. Ability to analyze billing accuracy and medical policy adherence.
2+ years customer service experience within the healthcare industry
Proficiency in using desktop software, such as Microsoft Excel and Word is required (Word - Create and edit documents. Excel - someone that can track/trend data.)
Monday thru Friday 9 AM to 5 PM
2+ years experience in Claims Adjudicating (This experience should be from a payers perception)
Bachelor's DegreeExperience working in a special project role
Microsoft SharePoint and Access experience is a plus
Develop ProcessesOptumInsight is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.OptumInsight is one of the largest and fastest growing health information companies. We specialize in improving the performance of the health system by providing analytics, technology and consulting services that enable better decisions and results. We integrate workflow solutions that deliver data in real-time, and create actionable insights processing health information that relates directly to and affects one in four patients in the U.S., one in every three Medicaid dollars and one in every five emergency room visits. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.What can YOU do with the right information? At OptumInsight, the possibilities and the impact are limitless. No matter what your role is at OptumInsight, you'll be empowered to ask more questions, develop better solutions and help make the health care system greater than ever. It's always fresh. It's always exciting. And it's never been more important.Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/VUnitedHealth 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 is the most diversified health care company in the United States and a leader worldwide in helping people live healthier...