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UnitedHealth Group

Senior Claims Business Process Consultant - US Telecommute

UnitedHealth Group - Minneapolis, MN

Position Description Position Description:Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.SM Our claims operations, including our Senior Claims Business Process Consultants, are the focal point of handling information about services patients receive and the way those services get paid. It's complex, detailed work. It's fast paced challenge. It's a job that calls on you to be thoughtful, resourceful, team-driven and customer-focused. To put it mildly, there is never a dull moment.Primary Responsibilities:Implement appeal review processes that align with upstream business processes and meet regulatory requirementsConduct root cause analysis on drivers of appeals, contact, and overturn rate Ensure data integrity, data security and process optimizationPartner with functional area leaders and SMEs to determine impact and solutionsImplement appeal ops solutions to reduce contact and overturn rateCollaborate with training partners to design training solutions of identified projects Required Qualifications:Bachelor’s degree (or higher) OR High School diploma / GED with 4 years of equivalent experience Comfortable with travel up to 2 times per year2 years of experience analyzing and solving customer problems in an office setting environment3 years in a technical or metrics based environment; preferably claims and/or customer service Proficient with a computer and Windows PC applications, which includes the ability to learn new complex computer system applicationsAble to create, copy, edit, save and send documents utilizing Microsoft Word, Excel & OutlookPreferred Qualifications:Intermediate skills in Microsoft Excel - create formulas; PowerPoint - create slide shows; Outlook - be able to create emails, and Visio - using chartsDemonstrated understanding of key HIPAA requirements and regulatory guidelinesExperience with process improvement, workflow, benchmarking and / or evaluation of business processesProject Management experienceSupervisory or Team Lead experienceKnowledge of COSMOS, NICE, and FACETS Careers atUnitedHealthcare Medicare & Retirement. The Boomer generation is the fastest growingmarket segment in healthcare. And we are the largest business in the nationdedicated to serving their unique health and well-being needs. Up for thechallenge of a lifetime? Join a team of the best and the brightest to find boldnew ways to proactively improve the health and quality of life of these 9million customers. You'll find a wealth of dynamic opportunities to grow anddevelop as we work together to heal and strengthen our Healthcare system.Ready? It's time to do your life’s bestwork.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.Keywords: UHG, Telecommute, Claims, Healthcare, Appeals

10 days 1 hour ago

UnitedHealth Group


Senior Claims Business Process Consultant - US Telecommute UnitedHealth Group - Minneapolis, MN, United States


Location: Minneapolis, MN

Company Profile:
About UnitedHealth Group 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