Senior Recovery / Resolutions Representative - Eden Prairie, MN

UHG Eden Prairie, MN

About the Job


Energize your career with one of Healthcare’s fastest growing companies.  

 

You dream of a great career with a great company – where you can make an impact and help people.  We dream of giving you the opportunity to do just this.  And with the incredible growth of our business, it’s a dream that definitely can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives.  We live for the opportunity to make a difference and right now, we are living it up.

 

This opportunity is with one of our most exciting business areas: Optum – a growing part of our family of companies that make UnitedHealth Group a Fortune 6 leader.

 

Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.


The health care system is still evolving at a rapid pace. Technology is driving new advances in how patient care is delivered and how it's reimbursed. Now, UnitedHealth Group invites you to help us build a more accurate and precise approach to claims adjudication. As part of our Recovery and Resolutions team, you'll help understand and overcome errors in claims processing. You'll have all the tools and backing you need to help manage subrogation files, negotiate settlements and ensure adherence to compliance policies. All the while, you'll be building your career with a leader and reaching for the highest levels of performance as you do your life's best work.SM


When you are in the business of health care, you're in the business of people. At UnitedHealth Group we want every customer experience to be distinctly personal. The challenge is complex. When people call us for help, their focus is on getting the best care possible. We help them understand their benefits and their options. This part of their lives matters a lot to them and it matters just as much to us. Our customer service teams have a serious responsibility to make every contact informative, productive, positive, and memorable for what it says about how much we care.

 

Under minimal supervision accepts and directs all incoming phone calls according to policy and procedures and department productivity and quality standards. Resolves routine to moderately complex issues, refers appropriately to Team Lead and  /or Supervisor as needed.

 

Primary Responsibilities:

  • Answer in - coming calls from the Provider Inquiry Line and the Fraud Hotline. Incoming calls can be from members and / or Providers questioning claim status, review status, appeal status and/or reporting of fraud.

  • Logging of all in - coming calls in a Call Tracking Documentation System.

  • Maintains accuracy standards of 97% or greater.

  • Maintains adherence standards of 95% or greater.

  • Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance.

  • Works independently and as part of a team.

  • Act as a resource for others.


Requirements:

  • High School Diploma or GED

  • 2+ years of experience within the healthcare, claims, or insurance industries

  • 2+ years of customer service / call center experience

  • Moderate proficiency with MS Office - Excel (data entry, reporting, data analysis)

Assets:

  • Bachelor's Degree (or higher )

  • Knowledge of medical terminology

Soft Skills:

  • Strong oral communication skills, listening abilities, and problem solving capabilities

  • Ability to maintain a pleasant, courteous and helpful demeanor at all times

  • Ability to process and route calls in a timely manner

  • Ability to diffuse irate or difficult callers

  • Ability to multi - task, this includes ability to understand multiple products and multiple levels of benefits within each product

Physical Requirements and Work Environment:

  • Frequent speaking, listening using a headset, sitting, use of hands / fingers across keyboard or mouse, handling other objects, long periods working at a computer

  • Service center environment with moderate noise level due to Representatives talking, computers, printers, and floor activity.

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health - related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.SM


Diversity 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    researching, resolving, credit, recovery, UHG, United Health Group