11/09/2022

Claims Representative - Remote in California

  • UnitedHealth Group
  • Charlotte, NC, United States

Job Description

If you are located within California, you will have the flexibility to telecommute* (work from home) as you take on some tough challenges.



Energize your career with one of Healthcare’s fastest growing companies.  



You dream of a great career with a great company – where you can make an impact and help people.  We dream of giving you the opportunity to do just this.  And with the incredible growth of our business, it’s a dream that definitely can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives.  We live for the opportunity to make a difference and right now, we are living it up.



This opportunity is with one of our most exciting business areas: Optum – a growing part of our family of companies that make UnitedHealth Group a Fortune 5 leader.



Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.



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.



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This position is full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00am – 5:00pm. It may be necessary, given the business need, to work occasional overtime or weekends.



*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


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 in Pharmacy Claims Handling
  • Proficiency with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
  • Ability to work our normal business hours of 8:00am – 5:00pm


Preferred Qualifications:




  • 1+ years of experience processing medical, dental, prescription or mental health claims


Telecommuting Requirements:




  • Reside within California
  • 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



OptumRx is an empowering place for people with the flexibility to help create change. Innovation is part of the job description. And passion for improving the lives of our customers is a motivating factor in everything we do.



If you're ready to talk about groundbreaking interactions, let's talk about what happens when a firm that touches millions of lives decides to gather results from millions of prescriptions every month and analyze their impact. Let's talk about smart, motivated teams. Let's talk about more effective and affordable healthcare solutions. This is caring. This is great chemistry. This is the way to make a difference. We're doing all this, and more, through a greater dedication to our shared values of integrity, compassion, relationships, innovation and performance.  Join us and start doing 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.



#RPO #YELLOW


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