Recovery Resolution Clerk
About The Position
This position follows a hybrid schedule with 2-3 days in-office days per week. Our office is located at 100 Airpark Center E 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. The Recovery Resolution Clerk is responsible for researching, analyzing, and resolving outstanding medical claims that are unpaid, aged, or denied. This role ensures timely reimbursement by communicating directly with commercial payers, reviewing claim statuses, and updating internal systems with accurate documentation. This position is full-time 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 – 5:00pm. It may be necessary, given the business need, to work occasional overtime. This will be on the job training and the hours during training will be during normal business hours. Monday – Friday.
Requirements
- High School Diploma / GED
- Must be 18 years of age OR older
- 1+ years of experience in a production environment
- Proficiency in MS Office with solid computer skills (e.g., experience working with multiple systems, keyboarding skills, Microsoft Word, and PowerPoint
- Ability to work 2-3 days per week onsite at 100 Airpark Center E Nashville, TN 37217
- Ability to work full-time 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 – 5:00pm. It may be necessary, given the business need, to work occasional overtime.
Nice To Haves
- Knowledge of medical billing, insurance claim processing, and payer requirements
- Experience using provider portals
- Understanding of coordination of benefits (COB) processes
- Reside within commutable distance to the office at 100 Airpark Center E Nashville, TN 37217.
- 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.
- Strong attention to detail and problem solving skills
- Ability to communicate professionally with payers and internal teams
- Proficient verbal and written English skills
- All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
Responsibilities
- Investigate unpaid or aged claims to identify the cause of nonpayment and determine required follow-up actions.
- Review and resolve denied claims, ensuring all necessary corrections or additional documentation are identified and submitted when appropriate.
- Initiate outbound phone calls to commercial payers to verify claim receipt, check claim status, obtain processing updates, and request reprocessing when necessary.
- Utilize medical provider portals to research claim details, confirm adjudication information, and track payer responses.
- Verify claims receipt and processing timelines to ensure compliance with payer guidelines.
- Gather and verify coordination of benefits (COB) information, including primary/secondary payer details, to ensure accurate billing and processing.
- Update the internal UI/system with current claim statuses, TPL information, documentation from payer interactions, and next-step actions.
- Collaborate with billing teams to resolve issues that impact claim payment.
- Maintain accurate records of all communications and follow-up activities.
- Meet departmental productivity and quality standards, ensuring timely resolution of outstanding claims.
Benefits
- a comprehensive benefits package
- incentive and recognition programs
- equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements)
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
