17 days old

Recovery Resolution Analyst Senior - Work from Home - 927572

Boston, MA 02109
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  • Job Code
    927572

If you are located in theMassachusettsarea,you will have the flexibility to telecommute (work from home) as you take on some tough challenges.

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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 lifes best work.SM

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The 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.

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This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of (8:00am - 5:00pm). This position requires 25% travel/ up to 4 days a month within the state of MA.

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Training will be conducted virtually from your home.

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

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Primary Responsibilities:

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  • Examine, assess, and document business operations and procedures to ensure data integrity, data security and process optimization.
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  • Investigate, recover, and resolve all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities
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  • Investigate and pursue recoveries and payables on subrogation claims and file management
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  • Initiate phone calls to members, providers, and other insurance companies to gather coordination of benefits information
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  • Process recovery on claims
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  • Ensure adherence to state and federal compliance policies, reimbursement policies, and contract compliance
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  • Use pertinent data and facts to identify and solve a range of problems within area of expertise
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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 /GED (or higher)
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  • 2+ years of experience with medical record auditing and researching claims information
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  • Coder Certification (CPC or CCS or equivalent) and/or RN or LPN
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  • Intermediate skills with Microsoft Excel (create, edit, sort, filter, pivot tables)
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  • Experience in healthcare
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  • Ability to travel 25%
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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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  • Associates degree (or higher)
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  • 1+ year project management experience
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  • 1+ year of experience analyzing data and identify cost saving opportunities
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  • Experience working in a field related to long term care service delivery
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  • Experience working with medical claims platforms
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  • Knowledge of Medicaid/Medicare Reimbursement methodologies
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  • Knowledge of claims processing systems and guidelines/processes
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Physical Requirements and Work Environment:

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  • Frequent speaking, listening using a headset, sitting, use of hands/fingers across keyboard or mouse, handling other objects, long periods working at a computer
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  • Service center environment with moderate noise level due to Representatives talking, computers, printers, and floor activity
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UnitedHealth Group is an essential business. The health and safety of our team members is our highest priority, so we are taking a science driven approach to slowly welcome and transition some of our workforce back to the office with many safety protocols in place. We continue to monitor and assess before we confirm the return of each wave, paying specific attention to geography-specific trends. At this time, 90% of our non - clinical workforce transitioned to a work at home (remote) status. We have taken steps to ensure the safety of our 325,000 team members and their families, providing them with resources and support as they continue to serve the members, patients and customers who depend on us. You can learn more about all we are doing to fight COVID-19 and support impacted communities at: https://www.unitedhealthgroup.com/newsroom/addressing-covid.html

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Careers 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 lifes 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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Keywords: claims, data entry, coding, medical coding, customer service representative, customer service, CSR, UnitedHealth Group, Optum, OptumRx, call center, UnitedHealthcare, health care, healthcare, office, phone support, training class, advocate,work at home, work from home, WAH, WFH, remote, telecommute, hiring immediately, #rpo

Posted: 2021-05-26 Expires: 2021-06-25

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 Senior - Work from Home - 927572

UnitedHealth Group
Boston, MA 02109

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