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The UHC Team Repricer is responsible for applying UHC provider network contracted rates and reimbursement policies accurately and efficiently to medical claims for UMR. Primary Responsibilities:
UHC Team Repricers ensure network contracts and reimbursement policies and procedures are priced accurately on affiliated medical claims
Recommend system changes on provider contracts that appear inaccurate in the NDB
Work with both internal and external customers to identify and resolve complex problems
Assist company affiliates with initial deployment and ongoing support of systems and processes for claim repricing including Willow and the Willow Macro
Other responsibilities may include involvement with fee schedule and contract review
Be able to assist with UHC projects and other tasks related to provider relations, as necessary and / or requested
Prioritize and organize own work to meet agreed upon deadlines
Manage inventory to ensure claims are repriced accurately and meet required turnaround time
Reprice claims fetched in Willow using the Willow Macro as well as CUS and Call Trak applications
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.