Claims Business Process Technician - National Remote
Dallas, TX, United States
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
You'll join a high caliber team where you're assisting, educating, problem - solving and resolving tenuous situations to the best possible outcomes. Bring your people skills, emotional strength and attention to detail. In return we offer the latest tools and most intensive training program in the industry. Get ready to start doing your life's best work.SM
Positions in this function are responsible for all related aspects of claim system processes and claim business rules. Includes claims systems utilization, capacity analyses / planning and reporting. Includes claims - related business and systems analysis. Ensures data integrity, data security and process optimization. *Employees in jobs labeled with ‘SCA’ must support a government Service Contract Act (SCA) agreement.
This position is full - time. Employees are required to work our normal business hours of 8:00 AM - 5:00 PM It may be necessary, given the business need, to work occasional overtime or weekends. Training will be conducted virtually from your home.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Company thought leader
Broad business approach
Resource to senior leadership
Develops pioneering approaches to emerging industry trends
Additional responsibilities for this role:
Onboarding of new clients to claim operations
Manage all aspects of non standard plans from implementation, to vendor and ongoing support
Directly oversee quarterly audits with our chosen supplier
Act as the Subject Matter Expert for Account Management and internally for all claims related support
Work directly with Vendors to ensure plan documents and work instructions contain relevant data needed for processing
Audit internal auditors weekly to ensure they are reviewing claims correctly
Own all compliance related changes to ensure proper adoption throughout the business
Own and maintain the Claims documentation and best practices for claims utilized by operations
Ensure all client facing materials accurately reflect claims related stats and documentation
Work with sales and Account Management on RFPs or other opportunities where claims support is needed
Align closely with Card Ops to ensure all auto substantiation and other card related functions related to claims are working as expected
Program manage any changes across teams when claim changes are identified
Stress test against established, agreed upon procedures to take a significant, statistically acceptable sample size monthly of processed claims to ensure compliance against policy, procedure and regulation
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.
Bachelor’s Degree (or higher)
7+ years of experience with working in a fast - paced claims environment
5+ years of experience in working with Flexible Spending Account and other Notional plans
Knowledge of ERISA governed plans
Knowledge of IRS sections 213D and 503 governing Notional Plan types
Ability to travel up to 25% of the time
Ability to work any 8-hour shift between the hours of 8:00 AM - 5:00 PM including the flexibility to work occasional overtime and weekends based on business need
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
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
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 Optum. Here's the idea. We built an entire organization around one giant objective; make the health system 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 $82,100 - $146,900. The salary range for Connecticut / Nevada residents is $90,500 - $161,600. 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.