Senior Recovery / Resolution Analyst
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 optimizationInvestigate, recover, and resolve all types of claims as well as recovery and resolution for health plans, commercial customers, and government entitiesInvestigate and pursue recoveries and payables on subrogation claims and file managementProcess payment on claimsEnsure 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 expertiseRequired Qualifications :
High School Diploma / GEDActive Certified Professional Coder (CPC) credentialMust be 18 years of age OR older2+ years of experience with claims auditing and researching claims information1+ years of coding experienceKnowledge of claims processing systems and guidelines / processesExperience in healthcare settingAbility 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 weekendsPreferred Qualifications :
Coding Certification (CCS or CPMA)1+ years of experience analyzing data and identifying cost saving opportunitiesKnowledge of Medicaid / Medicare Reimbursement methodologiesExperience with Microsoft Access (create, edit, format, manipulate data)Experience with OPRS (claims processing system)Experience working with medical claims platformsExperience 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 privacyMust live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet serviceAll employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter PolicyPay 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). 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. 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.