- Provide expertise or general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims
- Process claims in high production, driven environment, following process instructions (SOP’s) that are provided.
- Analyze and identify trends and provide reports as necessary
- Consistently meet established productivity, schedule adherence and quality standards
This is a challenging role that takes an ability to thoroughly review, analyze and research complex health care claims in order to identify discrepancies, verify pricing, confirm prior authorizations and process them for payment. You’ll need to be comfortable navigating across various computer systems to locate critical information. Attention to detail is critical to ensure accuracy, which will impact the timely processing of the member’s claim.
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.
- High School diploma / GED (or higher) OR equivalent years of work experience
- Proficiency with Windows PC applications, which includes the ability to navigate multiple programs and learn new and complex computer system applications
- Ability to toggle between multiple systems/platforms (5-7 systems) while utilizing multiple monitors.
- Must be able to read and comprehend technical documents
- Must be able to utilize a calculator and do basic math calculations
- 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
- 1+ years of experience in a related environment (i.e. office, administrative, clerical, customer service, etc.) and computers as the primary job tools
- 1+ years of experience processing medical, dental, prescription or mental health claims
- Ability or experience working within a team environment
- Strong communication skills