Senior Recovery/Resolution Analyst - Remote

Company: UnitedHealth Group
Location: Hartford
Posted on: June 25, 2022

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.SMThe Senior Recovery/Resolution Analyst will work with a team on researching issues to determine feasibility of reducing medical costs through prospective solutions of claim system processes and claim business rules.This position is full-time (40 hours/week) Monday to Friday. Employees have the option to work a flexible schedule. It may be necessary, given the business need, to work occasional overtime. We offer 2 weeks of paid training.*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.Primary Responsibilities:

• Examine, assess, and document business operations and procedures to ensure data integrity, data security and process optimization
• Investigate, recover, and resolve all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities
• Investigate and pursue recoveries and payables on subrogation claims and file management
• Initiate phone calls to members, providers, and other insurance companies to gather coordination of benefits information
• Process payment on claims
• Ensure adherence to state and federal compliance policies, reimbursement policies, and contract compliance
• Use pertinent data and facts to identify and solve a range of problems within area of expertiseYou'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)
  • 2+ years of experience with claims auditing and researching claims information
  • 1+ years of experience analyzing data and identify cost saving opportunities
  • Coder Certification (CPC, CCS, CPMA or equivalent) OR Nursing Degree (RN or LPN)
  • Experience working with medical claims platforms
  • Experience in healthcare
  • Knowledge of claims processing systems and guidelines/processes
  • Intermediate skills with Microsoft Excel (create, edit, sort, filter, pivot tables)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 servicePreferred Qualifications:
      • 2+ years of coding experience
      • Knowledge of Medicaid/Medicare Reimbursement methodologies
      • Experience with Microsoft Access (create, edit, format, manipulate data)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-militaryLearn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible. https://uhg.hr/vetCareers 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.SMColorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $25.63 - $45.72. The salary range for Connecticut / Nevada residents is $28.27 - $50.29. 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 incentivesDiversity 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.Keywords: #RPO, #Yellow

Keywords: UnitedHealth Group, Hartford , Senior Recovery/Resolution Analyst - Remote, Professions , Hartford, Connecticut