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Independent Dispute Resolutions Specialist

Independent Dispute Resolutions Specialist

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.

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

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 - 8 : 00pm EST. It may be necessary, given the business need, to work occasional overtime.

Primary Responsibilities :

  • Work with ClearHealth's Sr Director of IDR, IDR paralegals and IDR managers to assist in the eligibility review of provider-filed disputes and the uploading of arbitration briefs to CMS in support of the No Surprises Act legislation.
  • Developing plans and programs to support continuous quality improvement using applicable tools
  • Act as an essential contributor to the IDR Team throughout the IDR process.
  • Work independently in a fast-paced environment while following defined standards and procedures.
  • Effectively communicate with internal stakeholders, health care providers, clients, CMS, and independent arbiters.
  • 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 equivalent work experience
  • Must be 18 years of age OR older
  • Experience in a law firm or legal / litigation setting, claims processing or review, or medical billing
  • Experience with PC based software programs and automated database management systems; Microsoft Word (create and edit documents), Microsoft Excel (create, edit, sort, pivot spreadsheets), Microsoft Outlook (email and calendar management)
  • Ability to work 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 - 8 : 00pm EST. It may be necessary, given the business need, to work occasional overtime.
  • 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.
  • Soft Skills :

  • Demonstrated ability to multitask and work with a high-volume, task driven workload with short deadline
  • Demonstrated high level attention to detail
  • Proven ability to meet goals and objectives in a fast-paced work environment
  • Demonstrated excellent verbal and written communication skills
  • 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 $16.00 - $27.69 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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    Resolution Specialist • Dallas, TX, United States

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