Medical Claims Representative Associate

UnitedHealth Group • Las Vegas, NV

417d • $33,280 - $58,802 • Onsite

About The Position

The Medical Claims Representative Associate at UnitedHealthcare is responsible for adjudicating routine to complex medical claims under minimal supervision. This role involves monitoring and reporting desk inventory, ensuring compliance with established production, quality, and cycle time standards, and addressing any issues that arise during the claims process. The position is full-time, requiring employees to work an 8-hour shift during normal business hours, with options for alternate schedules.

Requirements

• High school diploma / GED or equivalent years of work experience.
• Must be 18 years of age or older.
• 6+ months previous experience in Medical/Dental insurance, office, or medical billing setting.
• 6+ months experience with Medical terminology, ICD-10, or CPT coding with an understanding of Insurance Certificates, Benefit Schedules, Provider/Group Contracts, and Standard Insurance Industry Practices.
• Ability to type at least 40 words per minute (WPM) on average utilizing alpha/numeric keystroke.
• Ability to work at least an 8-hour shift during normal business hours of Monday - Friday 7:00 AM - 5:00 PM PST onsite.

Nice To Haves

• 1+ years medical claims processing experience working with HMO/PPO or indemnity claims.

Responsibilities

• Adjudication of claims to quality and production standards applicable to this position.
• Monitor work inventory and submit non-I Max sheets completed accurately by the first day of each month.
• Analyze medical claims to ensure accurate claims adjudication in accordance with EOC, Benefit Schedules, and Provider Contracts.
• Release claims by deadline to meet company, state regulations, contractual agreements, and group performance standards.
• Identify and report problems to management.
• Resolve priority projects.
• Perform all job functions with a high degree of discretion and confidentiality in compliance with federal, SHS, and departmental confidentiality guidelines.

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Insurance Carriers and Related Activities
• Education Level: High school or GED