Claims Clerk

UnitedHealth Group•Tampa, FL

2d•$16 - $25•Remote

About The Position

This position is National Remote. You’ll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges. 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.

Requirements

High School Diploma / GED OR equivalent work experience
Must be 18 years of age OR older
1+ years of data entry experience
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 6:30am - 9:00pm CST. It may be necessary, given the business need, to work occasional overtime
Ability to keep all company sensitive documents secure (if applicable)
Required to have a dedicated work area established that is separated from other living areas and provides information privacy
Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Candidates are required to pass a drug test before beginning employment.

Nice To Haves

1+ years of experience working with medical and/ or dental claims
1+ years of 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
Ability to type 60+ WPM
Basic understanding of healthcare claims including ICD-10 and CPT codes

Responsibilities

Provide general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims.
Authorize the appropriate payment or 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