09/21/2022

Consultant, Analytic Development - Telecommute

  • UnitedHealth Group
  • Atlanta, GA, United States

Job Description

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

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

Primary Responsibilities:

  • Researching and developing potential claim overpayment hypotheses
  • Utilizing data mining tools (i.e. SQL, Access, Excel) in order to analyze data to support of their hypothesis
  • Researching policies, coding guidelines, and regulations that would support the hypothesis being developed
  • Developing Business Requirement Documentation in a clear, concise, and comprehensive manner
  • Clearly communicate concept to business partners/clients and be able to appropriately respond to questions relating to the logic utilized within hypothesis testing, documentation, and the analytic
  • Performing quality checks for claim overpayment results and monitoring analytic performance
  • Present research findings in a clear and concise manner utilizing data reports and summaries to support concepts


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:

  • 2+ years of experience in healthcare (billing, coding, auditing claims)
  • 1+ years of experience conducting analysis on large data sets
  • 1+ years of experience with claims processing or adjudication systems (Such as UNET, COSMOS, Facets, Diamond, etc. or provider billing / coding knowledge on Professional and Facility claims)
  • Understanding of healthcare payment methodologies, policies, and coding are necessary
  • Maintains working knowledge of coding standards, billing rules and regulations and knowledge of procedure and diagnosis codes (CPT, ICD10 coding, HCPCS, APC and DRGs)
  • Solid computer skills: MS Access, Excel, Word, PowerPoint

Preferred Qualifications:

  • Advanced degree in health care or medical field
  • Coding Certification through AAPC or AHIMA
  • 1+ years of SQL experience (PLSQL, Teradata, MySQL)
  • Technical Writing and/or Business Requirement Documentation experience
  • Knowledge of statistical methods used in the evaluation of healthcare claims data
  • Proficiency with SQL coding and ability to run test queries to ensure viability of concepts under review
  • Flexibility and ability to handle multiple priorities at the same time
  • Ability to think outside of the box and breakdown complex problems into individual root causes
  • Self-managed, self-starter with the ability to support multiple concurrent projects and meet tight delivery timelines
  • Excellent critical thinking and problem-solving skills
  • Solid communication and negotiation skills


To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $66,100 to $118,300. The salary range for Connecticut / Nevada residents is $72,800 to $129,900. 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.

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


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.
 


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