1+ months

Senior Claims Examiner - San Antonio, TX or Telecommute - 904041

San Antonio, TX 78205 Work Remotely
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  • Job Code
    904041

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieveyour lifes best work.(sm)

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This is a challenging role that takes an ability to thoroughly review, analyze, and research complex health care claims in order to identify discrepancies, verify pricing, confirm prior authorizations, and process them for payment. You'll need to be comfortable navigating across various computer systems to locate critical information. Attention to detail is critical to ensure accuracy which will ensure timely processing of the member's claim.

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Youll enjoy the flexibility to telecommute* from within the U.S. as you take on some tough challenges.

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Primary Responsibilities:

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  • Assist with escalated claims to resolve complex issues for team members and internal customers
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  • Support implementation of updates to the current procedures and assist with new system training / mentoring
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  • Review guidelines as well as benefit plan documents and certificates to ensure proper benefits have been applied to each claim
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  • Analyze and identify trends and provide reports as necessary
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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
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  • 2+ years of healthcare related experience in an office setting (preferably within claims processing or examining, medical reception, customer service, billing or coding)
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  • Proficiency with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications
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  • Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained
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Preferred Qualifications:

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  • 3+ years of experience in a related environment (i.e. office, administrative, clerical, customer service) using phones and computers as the primary job tools
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  • 1+ years of claims examining experience (processing provider claims, medical, dental, prescription, and/or mental health claims)
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Careers with WellMed.Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 380,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to doyour life's best work.(sm)

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Colorado Residents Only: The hourly range for Colorado residents is $17.12 to $30.34. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

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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: medical claims examining, claims processing, customer service, medical reception, healthcare, insurance, health plan, managed care, medical billing, medical coding, provider claims, WellMed, San Antonio, TX, Texas

Posted: 2021-01-16 Expires: 2021-04-24

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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Senior Claims Examiner - San Antonio, TX or Telecommute - 904041

UnitedHealth Group
San Antonio, TX 78205

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