Job Description

This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. 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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

The Senior Recovery / Resolution Analyst will work with a team on researching issues to determine feasibility of reducing medical costs through prospective solutions of claim system processes and claim business rules.

This position is full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00am - 5:00pm. It may be necessary, given the business need, to work occasional overtime or weekends.

We offer on-the-job training. The hours of the training will be aligned with your schedule.

Primary Responsibilities:

• Examine, assess, and document business operations and procedures to ensure data integrity, data security and process optimization

• Investigate, recover, and resolve all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities

• Investigate and pursue recoveries and payables on subrogation claims and file management

• Process payment on claims

• Ensure adherence to state and federal compliance policies, reimbursement policies, and contract compliance

• Use pertinent data and facts to identify and solve a range of problems within area of expertise

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

• Active Certified Professional Coder (CPC) credential

• Must be 18 years of age OR older

• 2+ years of experience with claims auditing and researching claims information

• 1+ years of coding experience

• Knowledge of claims processing systems and guidelines/processes

• Experience in healthcare setting

• Ability to work full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00am - 5:00pm. It may be necessary, given the business need, to work occasional overtime or weekends

Preferred Qualifications:

• Coding Certification (CCS or CPMA)

• 1+ years of experience analyzing data and identifying cost saving opportunities

• Knowledge of Medicaid / Medicare Reimbursement methodologies

• Experience with Microsoft Access (create, edit, format, manipulate data)

• Experience with OPRS (claims processing system)

• Experience working with medical claims platforms

• Experience with Microsoft Excel (create, edit, sort, filter)

Telecommuting Requirements:

• Ability to keep all company sensitive documents secure (if applicable)

• Required to have a dedicated work area established that is separated from other living areas and provides information privacy

• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 - $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Job Tags

Hourly pay, Minimum wage, Full time, Contract work, Work experience placement, Live in, Local area, Remote work, Monday to Friday,

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