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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 impact the timely processing of the member's claim.
- Provide expertise or general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims
- Analyze and identify trends and provide reports as necessary
- Consistently meet established productivity, schedule adherence and quality standards
- High School Diploma / GED (or higher)
- Proficiency with Windows PC applications, which includes the ability to navigate multiple programs and learn new and complex computer system applications
- 1+ years of experience in a related environment (i.e. office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools
- 1+ years of claims processing experience OR 1+ years of Student Resources experience
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.
Keywords: Healthcare, health care, Managed Care, Billing Representative, Billing, Collections, Claims, Customer Service, Medical Billing