Position Description: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 doing your life's best work.As a Recovery / Resolutions Representative, you'll be responsible for reviewing healthcare claims to uncover any inaccurate payments and then take the necessary steps to recover any over - payment of funds. This means you'll review specific claim, member and contract information to determine if all is in compliance. Communication, documentation and resolving any over - payments will then comprise the rest of your role.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 (6:00 AM - 5:00 PM). It may be necessary, given the business need, to work occasional overtime or weekends.Primary Responsibilities:Provides claims support to our COB (Coordination of Benefits Group) by reviewing, researching, investigating, negotiating and resolving all types of claims related to incorrect or over - paymentsPerforms additional research verifying the member status, eligibility and coverage according to the specific contract to identify any issues / accuracy or the possibility of any third party responsibilityCompletes on a daily basis all data entry required to document and communicate the status of claims as needed adhering to all reporting requirementsCommunicate via phone, letters or emails, over - payment information to payers / providers or members, including explanations of the reason for the over - paymentsNegotiates with applicable parties (other insurance carriers, members, providers or attorneys) the claim recovery amounts required, secures payment and ensures the crediting of the amount to the correct claim / over - payment.Meet the performance goals established for the position in the areas of: efficiency, accuracy, quality, and attendance
Requirements:High School Diploma / GED1+ years of Customer Service Representative (CSR) or Claims Representative experience or 1+ years experience in an office setting, call center setting or phone support role1+ years experience working with Windows based PC applications including the ability to learn new and complex computer system applicationsAssets:Prior knowledge of claims processing procedures, systems and contract, privacy and government regulationsBasic Microsoft Excel skills: Ability to copy, paste, sort and filterSoft Skills:Ability to multi - task, this includes ability to understand multiple products and multiple levels of benefits within each productAbility to work regularly scheduled shifts within our hours of operation including the training period, where lunches and breaks are scheduled, with the flexibility to adjust daily schedule, and work over - time and / or weekends, as neededAll new hires will need to successfully complete the UnitedHealthcare Claims training classes and demonstrate proficiency of the materialCareers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near - obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.SMDiversity 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: recovery, claims, resolution, UNET, benefits, healthcare
Our mission is to help people live healthier lives and to help make the health system work better for everyone.
- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities.
- We work with health care professionals and other key partners to expand access to quality health care so people get the care t...hey need at an affordable price.
- We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.