Claims Clerk 

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities, and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? 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.

This position is full-time (40 hours / week), Monday – Friday. Employees must have the flexibility to work an 8 hour shift between the hours of 5:00 AM – 5:30 PM CST (Central Standard Time). It may be necessary, given the business need, to work occasional overtime and weekends.

We offer 8 weeks of paid training. The hours during training will be 7:00 AM – 3:30 PM CST from Monday – Friday. Training will be conducted virtually from your home.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

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 Supervisor
• Calculate other insurance and re – pricing benefits
• Work claims files to ensure the appropriate eligibility and provider records are matched to the claim
• Updates and maintains claims tracking database

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 
• 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 using computer and Windows personal computer applications, which includes the ability to learn new and complex computer system applications
• Ability to work any 8-hour shift between the hours of 5:00 AM – 5:30 PM CST (Central Standard Time) from Monday – Friday including the flexibility to work occasional overtime and weekends based on business need
• Must be 18 years of age OR older

Preferred Qualifications:

• 1+ years of experience in working with medical claims
• 1+ years of experience with working in a production – based environment
• Basic understanding of healthcare claims, including ICD – 9 and CPT codes
• Ability to type at the speed of 60+ WPM (words per minute)

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 privacy
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

California, Colorado, Connecticut, Nevada, New Jersey, New York, Washington, or Rhode Island Residents Only: The hourly range for California / Colorado / Connecticut / Nevada / New York / New Jersey / Washington / Rhode Island residents is $16.00 – $23.13 per hour. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.