About the position
UMR, UnitedHealthcare's third-party administrator (TPA) solution, is the nation's largest TPA. When you work with UMR, what you do matters. It's that simple . . . and it's that rewarding. 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. Opportunities are endless for your career development and advancement within UMR due to our record-breaking growth. Regardless of your role at UMR, the support you feel all around you will enable you to do what you do with energy, quality, and confidence. So, take the first step in what is sure to be a fast-paced and highly diversified career. The Claims Clerk is responsible for providing expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing, and adjusting claims. This position is full-time, Monday - Friday. Employees are required to have flexibility to work any of our shift schedules during our normal business hours of 7:00 AM - 3:30 PM CST. It may be necessary, given the business need, to work occasional overtime and weekends. You'll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.
Responsibilities
- Provide general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims.
- Refers claims to investigators for further review.
- Conduct data entry and re-work; analyzes and identifies trends and provides reports as necessary.
- Analyze and identify trends and provide reports as necessary.
- Consistently meet established productivity, schedule adherence, and quality standards.
- Recognize claims by determining claim type - HCFA, Hospital, UB, Dental and/or RX.
- Identify more complicated claims and refer them to Senior Claim Processor or Supervisor.
- Work claims files to ensure the appropriate eligibility and provider records are matched to the claim.
- Updates and maintains claims tracking database.
Requirements
- High School Diploma / GED OR equivalent work experience.
- Must be 18 years of age OR older.
- 2+ years of experience with Microsoft Excel and Microsoft Outlook, including the ability to create, edit, save, and send documents, spreadsheets, and correspondence.
- Basic proficiency with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications.
- Ability to work any of our full time shift schedules during our normal business hours of 7:00 AM - 3:30 PM CST from Monday - Friday. It may be necessary, given the business need, to work occasional overtime and weekends.
Nice-to-haves
- 2+ years of data entry experience.
- 1+ years of experience in working with medical claims.
- 1+ years of experience with working in a production-based environment.
- 1+ years of experience in an office setting environment using a computer as the primary instruments to perform job duties.
- Basic understanding of healthcare claims.
- Ability to type at the speed of 60+ WPM.
Benefits
- Comprehensive benefits package.
- Incentive and recognition programs.
- Equity stock purchase.
- 401k contribution.
