1+ months

Senior Recovery / Resolution Analyst - Remote - 930251

Dallas, TX 75201 Work Remotely
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  • Job Code
    930251

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

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Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doingyour life's best work.SM

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TheSenior Recovery / Resolution Analystwill 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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Positions in this function are responsible for investigating, recovering and resolving all types of claims as well as recovery and resolution for health plans, commercial customers and government entities. May include initiating telephone calls to members, providers and other insurance companies to gather coordination of benefits data. Investigate and pursue recoveries and payables on subrogation claims and file management. Process recovery on claims. Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance. May conduct contestable investigations to review medical history. May monitor large claims including transplant cases.

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  • Generally, work is self-directed and not prescribed
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  • Works with less structured, more complex issues
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  • Serves as a resource to others
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We offer 3 weeks of paid training. The hours during training will be 8:00am to 5:00pm Monday-Friday.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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  • Coding certification (any of the following: CPC, CPC-H, CPC-P, CCA, CCS, CCS-P, RHIT, or RHIA), or an RN or LPN license
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  • Experience working with medical claims platforms
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  • 2+ years of experience with claims auditing and researching claims information
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  • 1+ year of experience analyzing data and identify cost saving opportunities
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  • Knowledge of claims processing systems and guidelines/processes
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  • Intermediate skills with Excel (pivot tables and formatting cells)
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  • Experience in healthcare
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  • If you need to enter a work site for any reason, you will berequiredto 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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  • Bachelor's degree (or higher)
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  • 1+ year project management experience
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  • Knowledge of Medicaid/Medicare reimbursement methodologies
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  • Experience using MicrosoftAccess (filtering and sorting)
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Telecommuting Requirements:

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  • Required to have a dedicated work area established that is separated from other living areas and provides information privacy
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  • Ability to keep all company sensitive documents secure (if applicable)
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  • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
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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.

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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 doyour lifes best work.SM

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Colorado Residents Only: Thehourly range for Colorado residents is $25.63 to $45.72. 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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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 Groupis a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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Keywords:Optum, Healthcare, Recovery, Resolutions, US Telecommute, Clinical, Collections, RN, LVN / LPN, medical coding, work at home, work from home, WAH, WFH, remote, telecommute, hiring immediately,#RPO

Posted: 2021-05-08 Expires: 2021-07-07

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 Recovery / Resolution Analyst - Remote - 930251

UnitedHealth Group
Dallas, TX 75201

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