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Job Details


UnitedHealth Group

Supplemental Health Claims Analyst - National Remote

Healthcare

Home Health

Yearly

No

Dallas, Texas, United States

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

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

This is a multitasking position. The Supplemental Health Claims Analyst will handle claims, reach the members & employers, request medical records, do full assessments of the claims, & be proficient in writing claims / letters (Write adverse claims letters). Call center will take basic inquiries and will be escalated to claims representative, make 4 – 10 outbound calls per day (Mondays – heavy claims calls).

This position is full-time (40 hours per week). Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 9:00am – 4:00pm. It may be necessary, given the business need, to work occasional overtime.

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

Primary Responsibilities:

  • Implement claim payment processes that meet regulatory requirements and claim business rules
  • Conduct claims systems utilization, capacity analysis/planning and reporting, and claims-related business and systems analysis
  • Ensure data integrity, data security and process optimization
  • Serve as our internal Regulatory Affairs' point of contact
  • Partner with functional area leaders and SMEs to determine impact and solution
  • Implement Claim ops solutions to meet regulatory requirements
  • Lead Claim Ops market conduct or financial exam activity, corrective action plans responses and restitution projects
  • Remediate gaps in existing production processes that do not meet regulatory requirements

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 equivalent work experience
  • 1+ years’ experience providing customer service to policyholders, employers, internal and external customers
  • Experience with Microsoft Word (basic Microsoft word skills to write letters) and Excel (ability to create spreadsheets, basic formulas needed to create reporting)
  • 2+ years’ experience analyzing and problem-solving issues in a customer service setting
  • Ability to work any of our 8-hour shift schedules during our normal business hours of 9:00am – 4:00pm. It may be necessary, given the business need, to work occasional overtime.

Preferred Qualifications:

  • 1+ years of Claims processing experience
  • Microsoft Access and Visio experience (create, edit, format, manipulate data)

Telecommuting Requirements:

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

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at https://uhg.hr/transitioning-military

Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible. https://uhg.hr/vet

Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of healthcare. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life’s best work.SM

Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $45,100 - $80,200. The salary range for Connecticut / Nevada residents is $49,800 - $88,200. 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.

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.

Keywords: #RPO, #YELLOW

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