Senior Recovery / Resolutions Representative

UnitedHealth Group
Frederick, MD
Sep 15, 2017
Sep 18, 2017
Accountant, IT
Full Time
Position Description: Energize your career with one of Healthcare's fastest growing companies. You dream of a great career with a great company - where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it's a dream that definitely can come true. Already one of the world's leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our Service Centers, improve our Service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up. This opportunity is with one of our most exciting business areas: Optum - a growing part of our family of companies that make UnitedHealth Group a Fortune 14 leader. Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions, and treatments; helping them to navigate the system, finance their Healthcare needs, and stay on track with their Health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation, and Performance.The Senior Recovery / Resolution Representative handles information about patient services and how those services are paid by investigating and pursuing recoveries through contact with various parties. Primary Responsibilities: Provide claims expertise support by reviewing, researching, investigating, negotiating, and resolving all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities Ensure adherence to state and federal compliance policies, reimbursement policies, and contract compliance Perform other duties as assigned Develops and expands knowledge of COB Rules, basic Computer skills and business etiquette Performs basic and specialty workflow and administrative tasks with minimal supervision Collaborates with others to identify and solve moderate problems and create procedures that promote efficiency and quality Initiates telephone calls to members, providers and other insurance companies to gather COB data Receives and respond to incoming telephone inquiries Determines primacy using published COB Updates eligibility system / database with outcome of primacy investigation Documents and communicates outcome of investigation following departmental procedures Meets productivity, quality and timeliness goals Responds to routine or standard requests to meet customer needs Focuses on Customer; exceeds expectations and improves customer experience Makes fact - based decisions; uses sound judgment and applies business knowledge Acts ethically; demonstrates integrity, complies with all laws, regulations and policies Required Qualifications: High School Diploma / GED or higher Experience working with Microsoft Word (document creation), Excel (basic spreadsheet, sorting, and data entry), PowerPoint (basic presentation creation), and Outlook (sending emails) Any experience with US Healthcare and / or COB experienceSoft Skills: Excellent written, analytical and verbal communications skills Ability to work in a production environment and meet / exceed productivity, quality and timeliness goals Team player; works effectively with others. Ability to work independently and exercise sound judgmentPhysical Requirements and Work Environment: Frequent speaking, listening using a headset, sitting, use of hands/fingers across keyboard or mouse, handling other objects, long periods working at a computer Service center environment with moderate noise level due to Representatives talking, computers, printers, and floor activityCareers 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.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: claims, medical claims, healthcare claims, claims processing, claims processor; office, UnitedHealth Group, Optum, training class, customer service representative, customer service, CSR, Data Entry, adjustments, phone support

Similar jobs