Quality Assurance Analyst

UnitedHealth Group•Minneapolis, MN

2d•$24 - $43•Remote

About The Position

This position is Remote in Central, Mountain, or Pacific Time Zones. You will have the flexibility to work remotely 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. The Quality Assurance Analyst primary responsibilities are to conduct reviews during the Itemized Bill Review active claim process and provide feedback to reduce errors and improve processes and performance. 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 6:30 am - 3:30 pm MST. It may be necessary, given the business need, to work occasional overtime. We offer weeks of on-the-job training. The hours of the 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
3+ years of healthcare industry experience working with appeals and/or medical claims
2+ years of remote/work from home experience
Experience with computers and Windows PC applications, which includes the ability to learn new and complex computer system applications
Experience with Microsoft Excel (data entry, sort / filter, and work within tables) and Microsoft Outlook (email and calendar management)
Ability to work between the hours of 6:30 am - 3:30 pm MST from Monday - Friday including the flexibility to work occasional overtime based on business need
Reside within Mountain, Pacific, or Central Time Zone
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.

Nice To Haves

3+ years of medical claims and / OR auditing experience
RemProduct / process knowledge
System / application knowledge

Responsibilities

Validate / analyze claim data for accuracy utilizing job aids, claim documents, policies, and procedures
Deliver / communicate fact-based quality review determinations in objective, non-confrontational manner
Provide supporting documentation for audit findings
Maintain tracking/reporting of daily tasks
Achieve production and quality goals/metrics
Identify / communicate uncommon patterns / trends to Team Lead / Manager