Senior Recovery Resolution Representative - Remote in Multiple Locations within Central Time Zone

Company: UnitedHealth Group
Location: Oklahoma City
Posted on: September 14, 2023

Job Description:

If you are located within the states of WI, IL, MN, AR, AL, IA, LA, MS, OK, or TN, you will have the flexibility to telecommute* (work from home) as you take on some tough challenges. Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The health care system is still evolving at a rapid pace. Technology is driving new advances in how patient care is delivered and how it's reimbursed. Now,--UnitedHealth Group--invites you to help us build a more accurate and precise approach to claims adjudication. As part of our Recovery and Resolutions team, you'll provide consultative support to our business units and external vendor organizations. You'll handle requests, define business requirements, and coordinate resolutions incorporating State and Federal regulations. Join us and build your career with an industry leader.This position is full-time (40 hours/week) Monday - Friday. Employees are required to work our normal business hours of 8:00am - 4:30pm CST We offer 6 to 8 weeks of paid training. The hours during training will be 8:00am to 4:30pm CST, Monday - Friday.-- Training will be conducted virtually from your home.*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.Primary Responsibilities:--

• Define and document/communicate business requirements.
• Analyze scope and resolution of medium to large size Operations Management (OM) and development requests.
• Serve as a key resource on complex and/or critical issues and help develop innovative solutions.
• Perform complex conceptual analyses.--
• Serve as a key resource on complex and/or critical issues and help develop innovative solutions.This is a challenging role with serious impact. You'll be assisting, educating, problem-solving and resolving challenging situations to the best possible outcomes. You'll need to understand and interpret clients' needs and ensure service and delivery excellence supporting the Fraud, Waste, Abuse, and Error product suite.-- This involves working with a high complexity solution set and cross functional teams to proactively review, research and resolve highly escalated inquiries.You'll 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.--Required Qualifications:--
  • High School Diploma / GED (or higher)
  • 2+ years of experience analyzing and solving problems.
  • 2+ years of experience with claims auditing, researching claims information, or payment integrity (experience healthcare billing, coding, claims, auditing, reimbursement, or data)
  • 2+ years of experience using any claims platforms such as UNET, Pulse, NICE, Facets, Diamond, etc.
  • Proficiency using Microsoft Excel (data entry, sorting/filtering, pivot tables, V-Lookups)
  • Ability to work full-time, Monday - Friday between 8:00am - 4:30pm CST Preferred Qualifications:
    • Bachelor's degree (or higher) OR 2+ years in a SME position
    • 1+ years of experience in health care claims recovery
    • Understanding of medical coding methodologies
    • Proficiency using Microsoft PowerPoint (create and edit presentations)
    • Basic ability to read/review SQL
    • Previous experience with Medicare/Medicaid paymentsTelecommuting Requirements:
      • Reside within the states of WI, IL, MN, AR, AL, IA, LA, MS, OK, or TN
      • Ability to keep all company sensitive documents secure (if applicable)
      • Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
      • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.Soft Skill:
        • Ability to produce within a fast paced, matrixed organization with limited direction.At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.-------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.--UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.--#RPO #YELLOW--

Keywords: UnitedHealth Group, Oklahoma City , Senior Recovery Resolution Representative - Remote in Multiple Locations within Central Time Zone, Other , Oklahoma City, Oklahoma