UnitedHealthcare Hiring for Division of UnitedHealth Group Job at Claims Representative – National Remote Full Time

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. 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 get. Leading edge technology in an industry that’s improving the lives of millions. Here, innovation isn’t about another gadget, it’s about making Healthcare data available wherever and whenever people need it, safely and reliably. There’s no room for error. Join us and start doing your life’s best work.SM

The Claims Representative is responsible for 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. They need to effectively manage their monthly metrics in a production driven environment and ensure they are meeting all compliance turnaround times mandated by the client. The Claims Rep must be proficient in computer skills and able to navigate multiple systems at one time with varying levels of complexity. They must have the ability to research and work independently on making decisions on complex cases.

Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 08:00am – 05:00pm.

• All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary Responsibilities:

• Research, identify and obtain data/information needed to help process claims or resolve claims issues (e.g., verify pricing, applicable benefits
• Ensure the proper benefits are applied to every claim
• Process medical records obtained after a request for records by accurate data entry of a claim.
• Collaborate with entire investigative team and provide assistance
• Perform administrative tasks/duties as assigned by management
• Include complex decision making that maximizes investigation opportunities for our client(s)

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 or GED (or higher)
• 1+ years of experience with COSMOS Platform and Claims Processing Workstation (CPW)
• 1+ years of health insurance business experience, including knowledge of industry terminology, claims processing and regulatory guidelines
• 1+ years of working in an environment where individual productivity and quality standards are measured
• Moderate proficiency of Microsoft office, Microsoft Word, Microsoft Excel
• Ability to work an 8-hour shift daytime hours Monday through Friday or hours aligned with Client Support Needs.
• Also need the ability to work overtime or weekends as business needs

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

Preferred Qualifications:

• Healthcare claims experience/processing experience
• Experience with Fraud Waste & Abuse or Payment Integrity

Soft Skills:

• Strong communication skills with the ability to interpret data

Physical and Work Environment:

• frequent speaking, listening using headset, sitting, use of hands/fingers across keyboard

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether 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 journey. Learn 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 possible. https://uhg.hr/vet

Careers with OptumInsight. Information and technology have amazing power to transform the Healthcare industry and improve people’s lives. This is where it’s happening. This is where you’ll help solve the problems that have never been solved. We’re freeing information so it can be used safely and securely wherever it’s needed. We’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 millions. This is where the best and the brightest work together to make positive change a reality. This is the place to do your life’s best work.SM

Colorado, Connecticut, Nevada or New York City Residents Only: The salary range for Colorado residents is $16.00 – $26.88. The salary range for Connecticut / Nevada / New York City residents is $16.83 – $29.66. 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

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.

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