Claims Associate Representative

Employer: UnitedHealth Group

Primary Responsibilities:

• Review, research, solve and process assigned work. This would include navigating multiple computer systems and platforms (e.g. verify pricing, prior authorizations, applicable benefits)
• Ensure that the proper benefits are applied to each claim by using the appropriate tools, processes and procedures (e.g. claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/ certificates tool)
• Independently complete on a daily basis all documentation and communicate the status of claims as needed adhering to all reporting requirements
• Communicate through correspondence with members and providers regarding claim payment or required information, using clear, simple language to ensure understanding
• Learn and leverage new systems and training resources to help apply claims processes/procedures appropriately (e.g. on-line training classes, coaches/mentors)
• Meet and maintain the performance goals established for the position in the areas of quality, production and attendance
• Consistent attendance with ability to meet work schedule including the required training period
• Successful completion of the UnitedHealth Group 12 to 14-week new hire training program which is 60% instructor lead and 40% self-paced learning (requires ability to read complex information and demonstrate proficiency through testing and practical application)

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 (or higher) OR 10+ years of equivalent working experience
• Working knowledge with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications (including comfort using macros efficiently)
• Experience working with multiple products and multiple levels of benefits within each product

Telecommuting Requirements:

• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Ability to keep all company sensitive documents secure (if applicable)
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

APPLY HERE