08/18/2022

Claims Processing Specialist - National Remote

  • UnitedHealth Group
  • Dallas, TX, United States
Part Time

Job Description

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 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.



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



Primary Responsibilities:




  • Provide expertise or general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims
  • Analyze and identify trends and provide reports as necessary
  • Consistently meet established productivity, schedule adherence and quality standards
  • Initiates various investigations
  • Request documentation and records from providers and vendors
  • Makes determinations on claims


This is a challenging role that takes an ability to thoroughly review, analyze and research complex healthcare 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 support 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.


Required Qualifications:




  • High School Diploma / GED (or higher) OR equivalent years of work experience
  • 1+ years of experience of reviewing and processing medical, accident, dental, prescription or mental health claims
  • Experience with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
  • Experience with performing regular, basic mathematic (addition, subtraction, percentages) calculations
  • Knowledge of ICD 10, CPT, HCPCS codes and medical terminology


Preferred Qualifications:




  • 6+ months of experience with coordination of benefits across multiple plans
  • Experience with reading and analyzing medical records


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


Soft skills:




  • Comfortable working with numbers
  • Detail oriented
  • Strong verbal and written communication skills
  • Ability to read and comprehend benefits and exclusions
  • Experience in a production and quality environment
  • Analytical reasoning and ability to make decisions


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 wherever 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



Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $16.00 - $26.88. The salary range for Connecticut / Nevada residents is $16.83 - $29.66. 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


Apply Now