11 days old

Claims Representative - Ontario, CA - 942244

Ontario, CA 91764
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  • Job Code
    942244

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 health care 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)

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Primary Responsibilities:

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  • Analyze professional claims to determine claims payment
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  • Apply claim reductions and denials as based on industry standard guidelines utilizing information displayed on each claim through CES review
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  • Apply proper benefit application based on service rendered
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  • Review authorizations
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  • Determine where capitated payment applies versus fee for service
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  • Monitor Error Queues and Denial queues for error corrections
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  • Seek assistance with claim questions through the Claims Trainer, Team Lead and Team Supervisor
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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.

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Required Qualifications:

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  • Knowledge of CMS-1500 claim form
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  • Understand Provider contracts
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  • Knowledge of ICD-10 diagnosis codes and CPT-4 procedure coding
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  • Microsoft Office knowledge
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Preferred Qualifications:

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  • Crystal Reports
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  • Xcelys claims processing system
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Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care 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)

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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.

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UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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Job Keywords: Claims Representative, Ontario, CA, California

Posted: 2021-07-17 Expires: 2021-08-16

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Claims Representative - Ontario, CA - 942244

UnitedHealth Group
Ontario, CA 91764

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