Senior Recovery Resolution Representative - Remote in Multiple Locations within Central Time Zone
Company: UnitedHealth Group
Location: Terry
Posted on: September 15, 2023
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Job Description:
If you are located within the states of WI, IL, MN, AR, AL, IA,
LA, MS, OK, or TN, you will have the flexibility to telecommute*
(work from home) as you take on some tough challenges.
Optum is a global organization that delivers care, aided by
technology to help millions of people live healthier lives. The
work you do with our team will directly improve health outcomes by
connecting people with the care, pharmacy benefits, data and
resources they need to feel their best. Here, you will find a
culture guided by diversity and inclusion, talented peers,
comprehensive benefits and career development opportunities. Come
make an impact on the communities we serve as you help us advance
health equity on a global scale. Join us to start Caring.
Connecting. Growing together.
The health care system is still evolving at a rapid pace.
Technology is driving new advances in how patient care is delivered
and how it's reimbursed. Now, -UnitedHealth Group -invites you to
help us build a more accurate and precise approach to claims
adjudication. As part of our Recovery and Resolutions team, you'll
provide consultative support to our business units and external
vendor organizations. You'll handle requests, define business
requirements, and coordinate resolutions incorporating State and
Federal regulations. 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 our normal business hours of 8:00am
- 4:30pm CST
We offer 6 to 8 weeks of paid training. The hours during training
will be 8:00am to 4:30pm CST, Monday - Friday. - Training will be
conducted virtually from your home.
*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 impact. You'll be
assisting, educating, problem-solving and resolving challenging
situations to the best possible outcomes. You'll need to understand
and interpret clients' needs and ensure service and delivery
excellence supporting the Fraud, Waste, Abuse, and Error product
suite. - This 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)
Ability to work full-time, Monday - Friday between 8:00am - 4:30pm
CST
Preferred Qualifications:
Bachelor's degree (or higher) OR 2+ years in a SME position
1+ years of experience in health care claims recovery
Understanding of medical coding methodologies
Proficiency using Microsoft PowerPoint (create and edit
presentations)
Basic ability to read/review SQL
Previous experience with Medicare/Medicaid payments
Telecommuting Requirements:
Soft Skill:
Ability to produce within a fast paced, matrixed organization with
limited direction.
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. -
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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 -
Keywords: UnitedHealth Group, Jackson , Senior Recovery Resolution Representative - Remote in Multiple Locations within Central Time Zone, Other , Terry, Mississippi
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