Reclamation Team Lead

UnitedHealth Group•Nashville, TN

9d•$23 - $42•Hybrid

About The Position

This position follows a hybrid schedule with 3-4 in-office days per week. Our office is located at 100 Airpark Center East, Nashville, TN 37217 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. Energize your career with one of Healthcare’s fastest growing companies. You dream of a great career with a great company – where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it’s a dream that definitely can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up. This opportunity is with one of our most exciting business areas: Optum – a growing part of our family of companies that make UnitedHealth Group a Fortune 5 leader. Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance. The Senior Recovery/Resolution Analyst will work with a team on researching issues to determine feasibility of reducing medical costs through prospective solutions of claim system processes and claim business rules. 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 8:00am - 6:00pm local time. It may be necessary, given the business need, to work occasional overtime. We offer on-the-job training. The hours of training will be from 8:00am - 6:00pm.

Requirements

High School Diploma / GED or equivalent work experience
Must be 18 years or older
1+ years of experience analyzing data and identifying cost saving opportunities OR relevant college courses including economics, statistics, data science, or finance
Experience in healthcare industry
Knowledge of claims processing systems and guidelines/processes
Knowledge of X12 EDI transactions
Intermediate skills with Microsoft Excel (create, edit, sort, filter, pivot tables)
Ability to work in the office 3-4 times a week
Ability to work any of our 8-hour shift schedules during our normal business hours 8:00am - 6:00pm. It may be necessary, given the business need, to work occasional overtime

Nice To Haves

2+ years of experience with claims auditing and researching claims information
Knowledge of Medicaid/Medicare/Commercial Reimbursement methodologies

Responsibilities

Examine, assess, and document business operations and procedures to ensure data integrity, data security and process optimization
Investigate, recover, and resolve all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities
Investigate and pursue recoveries and payables on subrogation claims and file management
Initiate phone calls to other insurance companies to gather coordination of benefits information
Process recovery on claims
Ensure adherence to state and federal compliance policies, reimbursement policies, and contract compliance
Use pertinent data and facts to identify and solve a range of problems within area of expertise

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.

Stand Out From the Crowd

Upload your resume and get instant feedback on how well it matches this job.

Upload and Match Resume