Job Category:
Customer Support/Client Care
Reference Code:
315012
Position Type:
Full Time, Employee
UnitedHealth Group is among the most ambitious Fortune 25 companies you'll ever meet. Through our family of businesses, we're working to make the health care system perform better for more people, in more ways than ever.

Simply put, we think the entire system can be greater than it's ever been. And that drives us to work harder, aim higher, and expect more from one another.

Here, you'll be empowered to make an immediate impact for millions of others. And you'll achieve more than you ever expected. How does that fit with your plans?
Senior Claims Business Process Consultant - Phoenix, AZ or Houston, TX - Multiple locations
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.

AmeriChoice 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.
 
If you're ready to help make health care work better for more people, you can make a historic impact on the future of health care at AmeriChoice.
 
We contract with states and other government agencies to provide care for over two million individuals. Working with physicians and other care providers, we ensure that our members obtain the care they need with a coordinated approach.
 
This enables us to break down barriers, which makes health care easier for our customers to manage. That takes a lot of time. It takes a lot of good ideas. Most of all - it takes an entire team of talent. Individuals with the tenacity and the dedication to make things work better for millions of people all over our country.
 
Position Description:
Positions in this function are responsible for all related aspects of claim system processes and claim business rules. Includes claims systems utilization, capacity analyses/planning and reporting. Includes claims-related business and systems analysis. Ensures data integrity, data security and process optimization.

 
You can be a part of this team. You can put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.


Qualifications:
  • 3 years of experience managing business requirement documents for IT projects is required

  • 3 years audit experience with claims research is required

  • Proficiency in MS Word, Excel, and PowerPoint is required

  • Experience in Diamond, COSMOS, and/or FACETS is preferred

  • Project management experience is preferred

  • Bachelor's Degree is preferred

  • Anticipates customer needs and proactively develops solutions to meet them.

  • Serves as a key resource on complex and/or critical issues.

  • Solves complex problems and develops innovative solutions.

  • Performs complex conceptual analyses.

  • Reviews work performed by others and provides recommendations for improvement.

  • Forecasts and plans resource requirements.

  • Authorizes deviations from standards.

  • May lead functional or segment teams or projects.

  • Provides explanations and information to others on the most complex issues.

  • Motivates and inspires other team members.

Diversity creates a healthier atmosphere:  equal opportunity employer M/F/D/V
 
UnitedHealth Group is a drug-free workplace. All candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.



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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.
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