08/16/2022

Recovery / Resolutions Representative - Eden Prairie, MN

  • UnitedHealth Group
  • Eden Prairie, MN, United States
Full Time

Job Description

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 position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of (8:00am - 5:00pm). It may be necessary, given the business need, to work occasional overtime.

Primary Responsibilities:

  • Research and resolve unbilled claims
  • Review medical record documentation to identify services provided by physicians and mid-level providers as it pertains to claims that are being filed
  • Verify appropriate CPT, ICD and HCPCS codes to ensure accurate claim filing
  • Responsible for working EDI claim rejections in a timely manner
  • Communicate with credentialing and pre-certification team to obtain corrected or additional data
  • Manage claims pending validation and submitting as necessary
  • Responsible for working EDI claims error in a timely banner
  • Identify system problems related to billing and collections
  • Creates and mails insurance claims and patient statements
  • Completes billing of paper claims to the proper payers (Medicare, Medicaid, insurance company, patient, or third-party administrator) for services provided; ensures accurate patient demographics for billing
  • Works with Collections Manager / Supervisor or other members of the Management Team on special projects as needed

What makes this a special challenge? For one, we want to create a quality experience for every person we serve. So the bar is high for accuracy, communications style and effectiveness. Also, you’ll need to be researching and resolving problems before, during and after calls within a high volume, demanding environment.

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)
  • Data entry skills and proficiency with Windows PC applications, which includes the ability to navigate multiple programs and learn new and complex computer system applications
  • Experience with online CRM tools (e.g. Salesforce; UHC Link, BCBS)
  • Able to work a 40-hour schedule within the operating hours of the site
  • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation.

Preferred Qualifications:

  • 2+ years of related billing and / or collection experience
  • Experience and / or knowledge in the health care industry (e.g. benefit, claims)
  • Medical terminology and ICD / CPT coding
  • Technical skills in the areas of EDI, systems analysis and process flows
  • Knowledge of submission and resubmission of medical claims
  • Knowledge of government and commercial policies and procedures

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 with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 5 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.SM

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, #RED


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