11/16/2022

Insurance Follow - Up Representative (SSM) - National Remote

  • UnitedHealth Group
  • San Jose, CA, United States

Job Description

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

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 Healthcare 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

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

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

Primary Responsibilities:

Outstanding Insurance claims resolution 80%

  • Review, analyze and resolve outstanding and/or denied claims that have been submitted to the payor for reimbursement.
  • Identify, document, and communicate root cause of trends in recurring denials as well as recommend solutions and/or process improvements to prevent future denials.
  • Contact payors regarding billing discrepancies, payment inconsistencies and/or other claim related issues. 
  • Research delinquent accounts to successful claim resolution. 

Document Management 20%

  • Works incoming correspondence, including Payor letters, denials and additional information requests necessary to process claims.
  • Submits necessary Payor reconsiderations and/or appeals to overturn denials.
  • Interprets explanation of benefits for appropriate follow up action.
  • Other duties as assigned.

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)
  • 1+ years of experience in a high-volume position resolving insurance claims
  • 2+ years of related Insurance Follow up experience
  • Medical terminology experience
  • Knowledge of payer policies and procedures
  • Independent, self-starter mentality with a proven track record of success in current role
  • Ability to work our normal business hours of 8:00am to 5:00pm CST, Monday-Friday

Preferred Qualifications:

  • Experience with billing
  • Experience with payer medical policies

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:

  • Strong computer skills
  • Effective in identifying and analyzing problems
  • Ability to prioritize workload

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 OptumInsight. Information and technology have amazing power to transform the Healthcare industry and improve people's lives. This is where it's happening. This is where you'll help solve the problems that have never been solved. We're freeing information so it can be used safely and securely wherever it's needed. We're creating the very best ideas that can most easily be put into action to help our clients improve the quality of care and lower costs for millions. This is where the best and the brightest work together to make positive change a reality. This is the place to do your life’s best work.SM

Colorado, Connecticut, Nevada or New York City Residents Only: The salary range for Colorado residents is $16.00 - $23.51. The salary range for Connecticut / Nevada / New York City residents is $16.00 - $25.77. 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.

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