1+ months

Recovery Resolution Analyst - Healthcare Claims - Ontario, CA - 920942

Ontario, CA 91764
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  • Job Code
    920942

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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The Recovery Resolution Analyst is responsible for the Healthplan and Provider billings, claims auditing, recovery and resolution of claims issues in conjunction with other functions within the Revenue Recovery department.
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"Primary Responsibilities:

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  • Submission of the Healthplan and Provider billings in a timely manner
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  • Generate and review all relevant claims data from the specified System
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  • Ability to analyze data and automate the current processes to make them more efficient
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  • Provide claims expertise support by reviewing, researching, investigating, negotiating, and resolving all types of claims issues
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  • Process Refund Checks and Debit Offsets and post recoveries to applicable System
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  • Reconcile the submissions & recoveries data and follow-up on outstanding Accounts
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  • This candidate is expected to work with the Revenue Recovery Team to identify and facilitate the Healthplan and Provider billing and recovery operations
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  • Actively participate in all aspects of the Revenue Recovery functions as needed
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  • Assist the Lead of the department with the month-end financial report
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  • Perform other duties as assigned
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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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  • High School Diploma or GED
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  • 5+years of working experience in Managed Health Care with emphasis in the following areas:
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  • Claims Data Analysis
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  • Healthplan and Provider Billings
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  • Interpretation of Healthplan DOFRs and Provider Contracts
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  • Reconciliation of Billing and Recovery data
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  • Strong analytical and problem solving skills coupled with strong attention to detail
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  • Intermediate proficiency in Microsoft Excel and Access with working knowledge of SQL
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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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  • Experience working with high volume of claims data
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  • Knowledge and experience in ICD-10 and HCPC coding
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  • Exceptional written and oral communication skills
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  • Capable of working with minimal supervision exercising independent judgment within the scope of knowledge.
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Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system 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 l

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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 Data Analyst, Managed Care, Healthcare, Provider Billing, DOFR, Provider Contract, Excel, Access, HCP-10, HCPC Coding, Ontario, CA, California

Posted: 2021-04-02 Expires: 2021-06-30

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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Recovery Resolution Analyst - Healthcare Claims - Ontario, CA - 920942

UnitedHealth Group
Ontario, CA 91764

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