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Senior Recovery / Resolution Representative – Remote

UnitedHealth Group

UnitedHealth Group, the parent organization of UnitedHealthcare and Optum, is one of the world’s leading diversified health care companies.

You’ll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.

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 help understand and overcome errors in claims processing. You’ll have all the tools and backing you need to help manage subrogation files, negotiate settlements, and ensure adherence to compliance policies. All the while, you’ll be building your career with a leader and reaching for the highest levels of performance as you do your life’s best work.SM

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. It may be necessary, given the business need, to work occasional overtime.

All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary Responsibilities:

  • Provide expertise by reviewing, researching, resolving all accounts from credit balance to bring final resolution and root cause analysis for health plans, commercial clients, and government entities
  • Fundamental Execution: Plan, prioritize, organize, and complete work to meet established production goals required by provider and payer clients, Optum goals, quotas, and deadlines in a fast-paced ever-changing environment.
  • Provide top quality by researching accounts fully, reviewing and adhering to payer, provider and Optum quality requirements.
  • Client facing account management:
  • Represent Optum and Optum’s core values; act as a liaison between provider clients, Optum and payer clients.
  • Communicate and/or meet with the provider client appropriately to ensure Optum is meeting their needs and expectations. Building a good rapport with the provider client contacts by establishing professional working relationships to ensure operational efficiency.
  • Anticipates client needs and proactively identifies solutions.
  • Be accountable for improving business operations.
  • Inventory Management:
  • Account’s receivables follow up, resolution and ensuring AR is resolved within 30 days. Follow up includes researching why inventory is outstanding with the provider and payer clients.
  • Manage multiple different inventory work queues and workflows including Multiple payers, provider client referred inventory and unsolicited inventory.
  • Reporting & Analysis: Analyze and identify trends, provide reporting as necessary to the provider clients, management, and Client Services.
  • Utilize various reports to manage inventory, follow up as needed and drive client relationships work independently with little direct onsite supervision.
  • Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance.

This is a challenging role with serious impact. You’ll need to sort through complex situations to understand and clarify where errors happened or where they may continue to happen. It’s a fast-paced environment that takes focus, intensity, and resilience.

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 Account Management or Customer Service experience.
  • Healthcare finance experience with a focus in auditing and/or analysis.
  • Intermediate level of proficiency with Microsoft Excel (i.e., sorting, summing, creating bar graphs, formulas).
  • Working Hours – business hours – 40 hours standard, overtime if business needs dictate but not regularly
  • Ability to travel, up to 25% of the time (generally local, but some overnight)
  • Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance.

Preferred Qualifications:

  • Bachelor’s Degree (or higher)
  • 3+ years of experience in claims recovery and resolution, or an operations-based environment
  • Previous leadership experience
  • Previous experience working in a client facing role and/or working onsite at a client site.

Telecommuting Requirements:

  • Required to have a dedicated work area established that is separated from other living areas and provides information privacy
  • Ability to keep all company sensitive documents secure (if applicable)
  • 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 Skills:

  • Strong communication and customer service skills.
  • Exceptional organizational/time management skills
  • Basic proficiency in math, thinking analytically and strategically.
  • Previous work within the community giving back or volunteering time and resources.
  • Ability to work in a dynamic environment both independently and in a group setting

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at https://uhg.hr/transitioning-military

Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible. https://uhg.hr/vet

Careers with Optum. Here’s the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world’s large accumulation of health – related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life’s best work.SM

Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $17.12 to $30.34. The salary range for Connecticut / Nevada residents is $18.80 to $33.41. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

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.

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Senior Recovery / Resolution Representative – Remote

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UnitedHealth Group

UnitedHealth Group, the parent organization of UnitedHealthcare and Optum, is one of the world’s leading diversified health care companies.

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