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Claims Representative

Claims Representative

UnitedHealth GroupDallas, TX, United States
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This position is National Remote. You'll enjoy the flexibility to telecommute

  • from anywhere within the U.S. as you take on some tough challenges.

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, dataand resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefitsand career development opportunities. Come make an impact on the communities we serve as you help us advance health optimizationon a global scale. Join us to start Caring. Connecting. Growing together.

This is a challenging role that takes an ability to thoroughly review, analyze and research complex healthcare 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 support timely processing of the member's claim.

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 : 00am - 6 : 00pm)

We offer up to 8 weeks of training based on experience with UNET. Monday - Friday, training hours may vary, 7am - 4 : 30pm CST must be flexible

Primary Responsibilities :

  • 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
  • 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 OR GED
  • Must be 18 years of age OR older
  • 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
  • Proficiency with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
  • Experience with UNET system processing medical or mental health claims
  • Ability to work fulltime, (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 : 00am - 6 : 00pm)
  • Preferred Qualifications :

  • Experience with UNET behavioral health claims processing
  • Telecommuting Requirements :

  • Ability to keep all company sensitive documents secure (if applicable)
  • Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
  • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.
  • All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
  • Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.74 - $31.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

    Application Deadline : This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

    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.

    UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

    UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

    #RPO

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    Claim Representative • Dallas, TX, United States

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