29 days old

Health Plan Claims Manager - UHC C & S - Telecommute in Oklahoma City or Greater Oklahoma City Area, OK - 920786

Oklahoma City, OK 73102 Work Remotely
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  • Job Code
    920786

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

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Transforming health care for everyone takes a huge effort. But we never said major impact was easy. At UnitedHealthcare, we are working to create a system that is connected, aligned and more affordable for all involved. One that delivers high quality care, responsive to the needs of each person and the communities in which they live.

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As part of the UnitedHealth Group family of businesses, we have the support and resources of a Fortune 7 industry leader to do so.

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As the Claims Manager, you'll be responsible for ensuring prompt and accurate claims processing for the Health Plan. You will also manage a staff of Claims Representatives who monitor billing activity and provide technical assistance and ensure encounter claims submitted are for actual rendered services performed and meet medical necessity. Responsible for fully understanding the claims process and effectively responding to and being the conduit between Claims and Leadership so we can accurately report to the State of OK Partners.

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If you are located in Oklahoma City or Greater Oklahoma City Area, OK, you will have the flexibility to telecommute* as you take on some tough challenges. You must be able to come into office as needed.

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Primary Responsibilities:

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  • Leadership of Claims processing for UHC C&S Oklahoma
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  • Coaches, mentors and provides guidance to multiple levels of staff
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  • Sets team direction in order to meet division quality, time service and productivity goals
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  • Daily monitoring of work queues and workflow
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  • Collaborates with Workforce Management on staffing needs and trends, and manages new hire process, from requests for approval, through on-boarding
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  • Leads meetings on a weekly or monthly basis, or other frequency, and attends and actively participates in other meetings as needed
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Youll 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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  • Undergraduate degree or 4+ years of equivalent work experience in health-related or insurance-related field
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  • 2+ years of experience as a Claims Manager
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  • 2+ years of leadership experience in health-related or insurance-related fields
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  • Knowledge of claim processing systems, policies and procedures
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  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders
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Preferred Qualifications:

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  • Claims Processing
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  • Managed Care related experience
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  • Project Management / Process Improvement
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  • Data entry experience
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  • Ability to work independently without direct supervision
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  • Strong organizational and time management skills, attention to detail and problem-solving, good written and verbal communication skills
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Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low-income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm)

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*All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy

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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: Health Plan Claims Manager, UHC, C&S, Claims Processing, Managed Care, Health Plan, Claims, Oklahoma City, Greater Oklahoma City Area, Midwest City, Norman, Edmond, Moore, Shawnee, OK, Oklahoma, Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Remote

Posted: 2021-03-23 Expires: 2021-05-21

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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Health Plan Claims Manager - UHC C & S - Telecommute in Oklahoma City or Greater Oklahoma City Area, OK - 920786

UnitedHealth Group
Oklahoma City, OK 73102

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