11/22/2022

Medical Claims Processor - National Remote

  • UnitedHealth Group
  • Tampa, FL, United States

Job Description

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

Imagine this. Every day, in claims centers around the world, UnitedHealth Group is processing and resolving payment information for millions of transactions. Would you think we have some great technology? Would you think we know how to manage volume? You would be right. No one’s better. And no company has put together better teams of passionate, energetic and all out brilliant Claims Representatives. This is where you come in. We’ll look to you to maintain our reputation for service, accuracy and a positive claims experience. We’ll back you with great training, support and opportunities.

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:

  • Research, identify and obtain data/information needed to help process claims or resolve claims issues  
  • Work is frequently completed with established Standard Operating Procedure documents 
  • Ensure that proper benefits are applied to every claim 
  • Apply knowledge of customer service requirements to process claims appropriately  
  • Identify and apply knowledge of new plans/customers to process their claims appropriately 
  • Collaborate with internal business partners to resolve claims errors/issues  
  • Achieve applicable performance metrics  
  • Use appropriate systems/platforms/applications to process claims 
  • Navigate systems tools and screens efficiently and effectively  
  • Use appropriate documentation, reference materials and/or websites to ensure that claims are processed accurately and efficiently  
  • Learn and use new systems/applications/resources as needed 

This is a challenging role that takes an ability to thoroughly review, analyze and research complex health care 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 impact the 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 or GED (or higher)
  • 6 months+ recovery or medical claim experience 
  • Ability to work from 8:00am - 5:00pm, Monday to Friday including the flexibility to work occasional overtime

Preferred Qualifications:

  • 1+ years of experience with Microsoft office 
  • Experience with CPW/CPA or COSMOS  
  • Previous experience working within Medical Insurance and/or Healthcare industry

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

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

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life’s best work.SM

Colorado, Connecticut, Nevada or New York City Residents Only: The salary range for Colorado residents is $16.00 - $17.07. The salary range for Connecticut / Nevada / New York City residents is $16.00 - $19.18. 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.

#RPO #YELLOW


Apply Now