Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work. Primary Responsibilities:
Audit paid claims data to identify duplicate payments or contractual, billing, and claim processing errors
Initiate phone calls to providers, employer groups, and other insurance companies to gather pertinent claim information, such as verification of billed charges, confirmation of services received, and coordination of benefits information
Work directly with other departments to enhance and refine assigned inventory to maximize value
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
Examine, assess, and document business operations and procedures to ensure data integrity, data security and process optimization
Investigate and identify over - payments on all claims types, as well as assist in recovery and resolution for health plans, commercial customers, and government entities as needed
Generally work is self - directed and not prescribed
UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.
We are committed to introducing innovative approaches, products and services that can improve personal health and promote healthier populations in local communities. Our core capabilities... in clinical care resources, information and technology uniquely enable us to meet the evolving needs of a changing health care environment as millions more Americans enter a structured system of health benefits and we help build a stronger, higher quality health system that is sustainable for the long term.
We serve our clients and consumers through two distinct platforms:
?UnitedHealthcare, which provides health care coverage and benefits services.
?Optum, which provides information and technology-enabled health services.