Position Description: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 errorsInitiate 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 informationWork directly with other departments to enhance and refine assigned inventory to maximize valueEnsure adherence to state and federal compliance policies, reimbursement policies, and contract complianceUse pertinent data and facts to identify and solve a range of problems within area of expertiseExamine, assess, and document business operations and procedures to ensure data integrity, data security and process optimizationInvestigate 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 neededGenerally work is self - directed and not prescribedWorks with less structured, more complex issuesServes as a resource to others
Required Qualifications:Bachelor's Degree (or higher) OR 1+ years of relevant experience (healthcare billing, claims, auditing, reimbursement, or data analysis)Ability to create and modify spreadsheets, documents, and presentations within Microsoft Excel, Word, and PowerPointPreferred Qualifications:2+ years of experience with claims auditing and researching claims information1+ years of experience analyzing data and identifying cost saving opportunitiesExperience working with medical claims platformsKnowledge of Medicaid / Medicare Reimbursement methodologiesKnowledge of claims processing systems and guidelines / processesExperience in Healthcare Physical Requirements and Work Environment:Frequent speaking, listening using a headset, sitting, use of hands / fingers across keyboard or mouse, handling other objects, long periods working at a computerService center environment with moderate noise level due to Representatives talking, computers, printers, and floor activityCareers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health - related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.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.Keywords: healthcare billing, claims, auditing, reimbursement, data analysis, advanced analysis, formulas, data capture, charts, graphs, presentations, Excel
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.