If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Financial discipline and accountability count more today than ever. Which is why your performance and innovation will find a reception here like nowhere else as you help people live healthier lives while doing your life's best work.(sm)
In providing consumer - oriented health benefit plans to millions of people; our goal is to create higher quality care, lower costs and greater access to health care. As a finance professional, you will be empowered to achieve new levels of excellence and make a profound and personal impact as you contribute to new innovations in a vital and complex system. Primary Responsibilities:
Oversees and manages the production schedules for pharmacy payment batches, tracer activity, projects and reporting. These activities are performed by onshore and offshore team members.
Perform account reconciliations and analyses
Assists on external and internal audits
Generate standard and ad - hoc reports as required
Develop innovative approaches for continued improvement in efficiency and effectiveness.
Assist with complex reconciliations that involve Billing and Payment data. In addition, perform, analyze and report on findings of the reconciliation
Assist with running and analyzing reports from claims data warehouse, RxC online reporting tools, MS Access & Excel
Partner with other departments, including Retail Network Ops, Provider Relations, Claims Operations and IT for payment batch / checks monitoring, payment tracer questions and other ad - hoc processes
Reviews weekly RXACH schedules and payment files
Performs network audit payment hold activities
Assists in creating yearly payment schedules
Performs key SOX controls for pharmacy payment accuracy, completeness and cutoff
Performs weekly unclaimed and abandoned property activities
Prepares reporting for client performance guarantees and CMS / state regulators for prompt pay compliance
Provides payment backup support for COGS / Claim Payable and billing / revenue Blackline recons
UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.
We are committed to introducing innovative approaches, products and services that can improve personal health and promote healthier populations in local communities. Our core capabilities... in clinical care resources, information and technology uniquely enable us to meet the evolving needs of a changing health care environment as millions more Americans enter a structured system of health benefits and we help build a stronger, higher quality health system that is sustainable for the long term.
We serve our clients and consumers through two distinct platforms:
?UnitedHealthcare, which provides health care coverage and benefits services.
?Optum, which provides information and technology-enabled health services.