9 days old

Escalated Claim Research Analyst - Phoenix, AZ

Phoenix, AZ 85003
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  • Job Code
    874855
We'll put you in the driver's seat on vital projects that have strategic importance to our mission of helping people lead healthier lives. Yes, we share a mission that inspires. We need your organizational talents and business discipline to help fuel ours. It's the opportunity to do your life's best work.(sm)

The Research + Escalation team is responsible for response and resolution of operational escalated issues are received by the Operations Account Management team. Operational issues may include, but are not limited to: (service, claims, eligibility, utilization management, prior authorization, payment integrity, provider data management, configuration, IT, project management, etc.)


The Escalated Research who are responsible for managing issues from inception to resolution, engaging the appropriate teams for assistance. The Research Analyst will be accountable for identifying trends and appropriately elevating to management for immediate action.


Primary Responsibilities:

  • Provide expertise and customer service support to members, customers and / or providers
  • Serve as the liaison to a complex customer base to manage first level response and resolution of escalated issues with internal and external customers
  • Identify and resolve operational problems using defined processes, judgement and expertise
  • Investigate claim and / or customer service issues as identified, and communicate resolution to customers
  • Provide feedback to team members regarding process improvement opportunities
  • Triage inquiries and requests received in the Market Operations group email box and submit an OEIM ticket, as appropriate. Analyst will support all Markets - 60% of Time
  • Prepares issues, trending, and reporting by collecting, analyzing, and summarizing complex data and metrics; present / explain findings and suggest enhancements and improvements
  • Manage non-escalated OEIM issues from receipt to resolution
  • Review operational processes to determine gaps and inefficiencies; raise issues to Operations Manager and / or respective Associate Director
  • Assist Associate Directors with requirement gathering sessions, when the local Markets are pursuing new initiatives and / or engaging in new projects that require support from operations, etc.

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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Posted: 2020-05-15 Expires: 2020-06-14

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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Escalated Claim Research Analyst - Phoenix, AZ

UnitedHealth Group
Phoenix, AZ 85003

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