UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.
UnitedHealthcare is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.
When you work with UnitedHealthcare, what you do matters. It's that simpleā¦and it's that challenging.
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. Join us and 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.
Position Description
Positions in this function are responsible for related aspects of claim system capability related to plan coding. Includes claims systems utilization, capacity analyses/planning. Includes claims-related business and systems analysis. Ensures data integrity, data security and process optimization.
Primary Responsibilities:
- Basic, structured, standard approach to work
- Programs the plan benefit coding system by interpreting the claim installation documents and the customer's specific plan document
- Maintains a working relationship with other units by developing coding schemes, clarifying, and resolving claim system coding capabilities
- Review processing questions for possible benefit coding corrections
- Participate in meetings by offering coding and auto adjudication suggestions and comments for new customers or changes to existing plans
- Monitor claims on recycle and reasons for the claim inventory
- Interpret and evaluate changes in laws and regulations and how they affect plan coding
- Contribute to the team effort by accomplishing related results as needed
Regardless of your role at UnitedHealthcare, the support you feel all around you will enable you to do what you do with energy, integrity, and confidence. So take the first step in what is sure to be a fast paced and highly diversified career.
Qualifications:
- 1 year claim experience required, (preferably medical or dental claims)
- Strong communication skills a must
- Undergraduate degree or equivalent experience
- Ability to analyze situations, consider alternatives, and effectively make sound decisions preferred
- Able to work in a quality / production environment a plus
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
