JOB DESCRIPTION

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. 

Primary Responsibilities:

• Accurate processing and completion of Physician/Pharmacy Claims
• Process claims that route out of automatic adjudication, within current turnaround standards
• Be able to analyze EOBs and denials at a claim level in addition they should find trends impacting dollar and #’s, leading to process improvements
• Analyze and trend data, recommending solutions to improve first pass denial rates and reduce age of overall AR
• Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so

Required Qualifications:

• Graduation from a recognized university OR Equivalent degree
• Minimum 12 months of experience in US healthcare accounts receivable (Denial Management)
• Good knowledge of medical insurance (HMO, PPO, Medicare, Medicaid, Commercial Payers)
• Comfortable working in night shift
• Good typing speed (English) and accuracy
• Proven excellent written and verbal communication skills
• Ability to understand and apply US healthcare plan concepts including Deductible, Coinsurance, Copay, Out of Pocket, etc.

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.