Provider Reimbursement Representative

At United Healthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

The Provider Reimbursement Representative is responsible for analyzing claims, pre and post payment, to ensure Surprise Medical Bill policies and procedures are handled accurately; review claim inquiries to verify correct procedures were applied and determine root cause of errors; recommend system changes, training and process improvements to prevent future errors; 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 to accurately and efficiently apply Surprise Medical Bill Federal Regulation. You’ll enjoy the flexibility to telecommute
* from anywhere within the U.S. as you take on some tough challenges.

• Provide the very best Customer Service to Internal / External customers
• Resolve Customer Service inquiries
• Surprise Bill Claim Review
• Apply knowledge / skills to activities that often vary from day – to – day
• Demonstrate a high level of knowledge and skills in own function
• Require little assistance with complex claim reviews
• Solve routine and complex problems on your own
• Prioritize and organize your own work to meet agreed upon deadlines
• Work with others as part of a team
• Assist with daily inventory review and assignment
• Assist with stop loss shifts as late as 9pm CT as assigned
• Participate in macro development
• Work with team members on challenging system processes for complex claims
• Analyze team processes for workplace efficiencies

• High School Diploma/GED (or higher) OR 2+ years of CPS claims experience/knowledge
• 1+ years of experience analyzing and handling claim inquiries
• 1+ years of experience processing HCFA and UB claims
• 1+ years of experience with UMR CPS processes
• Intermediate level of proficiency with Microsoft Excel (create, edit and update documents)

• Strong research and analytical skills
• Strong Interpersonal
  
  Skills:
  
  ability or desire to learn how to run small group meetings
• Strong business, written and oral communication skills
• Ability to handle a fast-paced environment with pressure based on project deadlines
• Organized and detail oriented

* All Telecommuters will be required to adhere to United Health Group’s Telecommuter Policy. For more information on our Internal Job Posting Policy, .Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).

No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.00 to $35.72 per hour based on full-time employment. We comply with all minimum wage laws as applicable. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

Final date to receive applications:
This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At United Health Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life.

Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes – an enterprise priority reflected in our mission.

United Health Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. United Health Group is a drug – free workplace.

Candidates are required to pass a drug test before beginning employment.

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