Medical Claims Representative Associate
About The Position
At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together The Medical Claims Representative Associate works under minimal supervision adjudicating routine to complex claims. They release designated pending claims to achieve established production, quality, and cycle time standards in accordance with EOC, Benefit Schedules and contractual arrangements. They monitor and report desk inventory notifying management of problem identification. This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 6:00 am - 5:00 pm. It may be necessary, given the business need, to work occasional overtime. We offer up to 4 - 6 weeks of paid training. The hours of training are Monday - Friday, 7:00 am - 3:30 pm PST. Training will be conducted onsite. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Requirements
- High school diploma / GED OR equivalent years of work experience
- Must be 18 years of age OR older
- 2+ years of experience in high-speed, accurate typing in a professional setting
- 6+ months of experience in Medical/Dental insurance, office or medical billing setting
- 6+ months of 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
- Onsite work at this location is a mandatory requirement for the role
- Candidates must reside within a reasonable commuting distance (typically within 30 - 60 minutes of travel time) of our office at 2720 N Tenaya Way, Las Vegas, NV 89128
- Ability to work Monday - Friday, employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 6:00 am - 5:00 pm. It may be necessary, given the business need, to work occasional overtime
- Must possess understanding of basic mathematics
- Demonstrated knowledge of or ability to learn and apply to job functions, those federal and state laws and regulations applicable to the operating unit
Nice To Haves
- 1+ years of 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 keep Average Review Time (ART) within standard. Report non- productive time to Management daily.
- Analyze medical claims to ensure accurate claims adjudication. Claims processing in accordance with EOC, Benefit Schedules and Provider Contracts.
- Release by deadline to meet Company, state regulations, contractual agreements and group performance standards.
- Problem identification and reporting to management.
- Resolution of priority projects.
- Performs all job functions with a high degree of discretion and confidentiality in compliance with federal, SHS and departmental confidentiality guidelines.
Benefits
- a comprehensive benefits package
- incentive and recognition programs
- equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements)
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
