Provider Reimbursement Specialist - Remote

UnitedHealth Group • Eden Prairie, MN

3h • Remote

About The Position

This specialist role with Optum, a UnitedHealth Group affiliate, will call on your knowledge, your energy and your commitment to making health care work more effectively for more people. We're driving ever higher levels of sophistication in how provider networks are composed and compensated. You'll be part of a team that's out to assist company affiliates with initial deployment and ongoing support of systems and processes that leverage contracted national network rates and policies. Join us and you'll discover the resources, backing and opportunities that you'd expect from a Fortune 6 leader. If you are looking for a challenge, this fast-paced, performance driven team environment is the place to be. You'll be expected to provide analytical expertise and accurate direction on pricing while meeting aggressive production goals. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Requirements

• High School Diploma / GED (or higher)
• 4+ years of health care/managed care experience
• 2+ years of CSP claim processing experience
• 1+ year(s) of experience with Medicare and Medicaid regulations
• Intermediate proficiency with Microsoft Word, Excel, PowerPoint and Access
• Current CSP access upon hire
• All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Nice To Haves

• Associate's Degree (or higher)
• CSP claims Subject Matter Expert (SME)
• CSP benefit configuration experience
• CSP claims auditing experience

Responsibilities

• Review email issues submitted by Skilled Nursing Facilities (SNF) and upload them into the Optum EnterpriseNow Issue Management tracking system
• Research, analyze, identify root cause correctly the first time, and coordinate resolution of claim issues with internal business partners
• Be accountable for accurate documentation and routing of issues to appropriate resolution partners
• Provide feedback and education to SNFs to reduce recurrence of billing errors
• Manage time effectively and balance workload and projects volume. The ability to prioritize, and multi-task effectively is required for success in this position
• Monitor progress of assigned claim issues and provide regular updates to the SNF contact
• Follow Team Standard Operating Procedures (SOP) and use Resource Guides during issue resolution
• Report the final resolution on assigned claim issues to the SNF contact. Communication must be accurate, clear, and effective
• Maintain compliance with all Federal/State regulations and UHG policies
• Communicate in terms that the listener/recipient will understand

Benefits

• Competitive base pay
• Comprehensive benefit program
• Performance rewards
• Management team commitment to your success
• Paid Time Off which you start to accrue with your first pay period
• 8 Paid Holidays
• Medical Plan options
• Participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life& AD&D Insurance
• Short-term disability and Long-term disability coverage
• 401(k) Savings Plan
• Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)

What This Job Offers

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