Post Audit Coordinator

UnitedHealth Group • Tampa, FL

20h • $24 - $43 • 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.
Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together.
Do you have experience building relationships with providers? Experience working in Fraud, Waste, Abuse, & Error? Are you a hotshot Microsoft Excel user? Want to work with an elite team of some of the brightest and most inventive people in the healthcare & technology industries? Optum is a health services business, part of the UnitedHealth Group family of companies, dedicated to making the health system work better for everyone. We serve people throughout the entire health system. Our team enjoys conversation-changing, life-changing, world-changing opportunities throughout their careers. Join us and see what it’s like to do your life's best work.
The Post Audit Program Coordinator is the central point-of-contact for providers after an audit occurs. Sending Audit and Appeal Determination letters, assessing value of claims, and conducting provider follow ups to obtain a signoff. This position supports the review of suspected waste & abuse of health insurance claims.
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 8am - 5pm EST. It may be necessary, given the business need, to work occasional overtime.
We offer 4 weeks of on-the-job training. The hours of training will be aligned with your schedule.
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
• Must be 18 years of age or older
• 2+ years of healthcare customer service experience
• Intermediate experience with MS Word & MS Excel
• Ability to work 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 8am - 5pm EST. It may be necessary, given the business need, to work occasional overtime

Nice To Haves

• 2+ years of health insurance experience
• MS Excel Pivot table experience
• Knowledge of FWAE or Payment Integrity
• Adaptability and savvy in navigating a large, matrixed organization

Responsibilities

• Respond to provider inquiries via the call agent line and by email, addressing questions and concerns related to claims with professionalism, accuracy, and prompt follow-up
• Research and investigate claim statuses by reviewing documentation, system records, and applicable guidelines before providing clear and concise responses
• Acts as the central point-of-contact for specific hospital and health systems
• Plays a pivotal role in building relationships and influencing providers to obtain signoff on audits
• Accountable for day-to-day tasks associated with claims, including sending audit findings and appeal determination responses and following up with providers
• Assist in obtaining and triaging provider appeals to the appropriate team for processing
• Ensure adherence to federal compliance policies, contract compliance
• Analyze and create necessary spreadsheets of data

Benefits

• In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).
• No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED