Welcome to one of the toughest and most fulfilling waysto help people, including yourself. We offer the latest tools, most intensivetraining program in the industry and nearly limitless opportunities foradvancement. Join us and start doing yourlife's best work.(sm) The Senior Recovery/Resolution Analyst will work with ateam on researching issues to determine feasibility of reducing medical coststhrough prospective solutions of claim system processes and claim businessrules. This position is full-time (40 hours/week) Monday-Friday. Employees are required to have flexibility to work any of our 8 hourshift schedules during our normal business hours of (8am - 5pm). It may benecessary, given the business need, to work occasional overtime. Our office islocated at 1009 Windcross Ct, Franklin, TN 37067.Responsibilities:Examine, assess, and document business operations andprocedures to ensure data integrity, data security and process optimizationInvestigate, recover, and resolve all types of claims aswell as recovery and resolution for health plans, commercial customers, andgovernment entitiesInvestigate and pursue recoveries and payables on subrogationclaims and file managementInitiate phone calls to members, providers, and otherinsurance companies to gather coordination of benefits informationProcess recovery on claims Ensure adherence to state and federal compliancepolicies, reimbursement policies, and contract compliance Use pertinent data and facts to identify and solve arange of problems within area of expertise
Required Qualifications:High school diploma or GEDExperience working with medical claims platforms2+ years of experience with claims auditing andresearching claims information1+ year of experience analyzing data and identify costsaving opportunitiesKnowledge of claims processing systems andguidelines/processesIntermediate skills with ExcelExperience in healthcare Preferred Qualifications:An undergraduates degree or higher 1+ year project management experienceKnowledge of Medicaid/Medicare ReimbursementmethodologiesMS Access Physical Requirements and Work Environment:Frequent speaking, listening using a headset, sitting,use of hands/fingers across keyboard or mouse, handling other objects, longperiods working at a computerService center environment with moderate noise level dueto Representatives talking, computers, printers, and floor activityCareers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to 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.
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 they 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.