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. SM The Claims Clerk is responsible for providing expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting claims. Primary Responsibilities: Provide general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims.Authorize the appropriate payment or refers claims to investigators for further review. Conduct data entry and re - work; analyzes and identifies trends and provides reports as necessary. Analyze and identify trends and provide reports as necessary Consistently meet established productivity, schedule adherence, and quality standards Recognize claims by determining claim type - HCFA, Hospital, UB, and / or RX Identify more complicated claims and refer them to Senior Claim Processor or SupervisorCalculate other insurance and re-pricing benefitsWork claims files to ensure the appropriate eligibility and provider records are matched to the claimUpdates and maintains claims tracking database
Requirements: High school diploma / GED or higher 1+ years of experience in an office setting environment using the telephone and computer as the primary instruments to perform job duties Basic proficiency with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications 2+ years data entry experienceBasic understanding of healthcare claims including ICD-9 and CPT codes Assets: 1+ years experience working with medical claims Prior experience working with IDX software 1+ years working in production based environmentType 60+ words per minuteSoft Skills:Ability to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each productPhysical Requirements and Work Environment:Extended periods of sitting at a computer and use of hands/fingers across keyboard or mouse Office environment Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in healthcare here. We serve the healthcare needs of low income adults and children with debilitating illnesses such as Cardiovascular Disease, Diabetes, HIV/AIDS and High-risk Pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive Healthcare, Community, and Government partners to heal healthcare and create positive change for those who need it most. This is the place to do your life's best work.SM 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.Keyword: data entry; Claims; Healthcare; Clerk; Phoenix
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.