Recovery Resolutions Representative - San Juan, PR

UnitedHealth Group•San Juan, PR

1d•Onsite

About The Position

The Recovery Resolutions Representative supports the two parts of the Prospective Investigations process by identifying and keying specific detail from the medical records and determine if the claims proceed with a payment. Incumbents are responsible for dealing professionally and ethically safeguarding confidential information, adhering to UHG’s Principles of Integrity and Compliance. This position is critical to the success of the Investigative teams and their ability to meet required internal and mandated turn-around times.

Requirements

1+ years of experience within a Healthcare environment using the computer as the primary instrument to perform job duties
Production environment experience
Working experience with Microsoft Tools: Microsoft Teams (join meetings and trainings), Microsoft Power Point (prepare presentations), Microsoft Word (creating memos, writing), Microsoft Outlook (setting calendar appointments, email) and Microsoft Excel (creating spreadsheets, filtering, navigating reports)
Ability to work (40 hours/week) Monday - Friday. Flexible to work any of our 8-hour shift schedules during our normal business hours of (6:00am to 6:00pm EST). It may be necessary, given the business need, to occasionally work mandatory overtime, holidays or weekends
English proficiency

Nice To Haves

Coding experience
Managed care experience
Claims processing experience
Medical records familiarity

Responsibilities

Data enter key detail from the medical records and claim platform into an online communication
Meet required productivity and quality metrics
Adherence to state and federal compliance policies and contract compliance
Assist the prospective team with special projects and reporting