Senior Claims Business Process Analyst

UnitedHealth Group•Tampa, FL

20h•$24 - $43•Remote

About The Position

This position is National Remote. You’ll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges. Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Senior Claims Business Process Analyst is responsible for supporting end-to-end claims process oversight, analysis, quality assurance, and process improvement initiatives. The role partners closely with business, operational, and technical teams to analyze claims system utilization, conduct capacity planning and reporting, and perform claims related business and system analysis. This position is full time (40 hours / week) in their respective time zone, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift, flexible hours schedules during our normal business hours of 6:00 am - 6:00 pm. It may be necessary, given the business need, to work occasional overtime. We offer 4 - 6 weeks of on-the-job training. The hours of training will be aligned with your schedule.

Requirements

High School Diploma / GED OR equivalent work experience
Must be 18 years of age OR older
2+ years of experience with analyzing and solving business OR customer issues
2+ years of experience in conducting end to end audits
Ability to manage multiple priorities in a fast paced environment
Proficiency with Windows-based applications and ability to learn complex systems and issues
Facets experience
Ability to work full time (40 hours / week) in their respective time zone, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift, flexible hours schedules during our normal business hours of 6:00 am - 6:00 pm. It may be necessary, given the business need, to work occasional overtime.

Nice To Haves

Claim adjustment experience
SharePoint experience
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
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Responsibilities

Perform in-depth, end-to-end research, data analysis, and root cause analysis to support claim quality remediation from initial issue identification through resolution
Own quality assurance activities related to payment accuracy, claim outcomes, and process improvement initiatives
Evaluate claim scenarios across the Facets platform, workflows, and business rules to identify gaps, trends, and downstream impacts
Partner with stakeholders to assess system changes, operational process enhancements, and remediation opportunities
Maintain claims process documentation, workflows, standards, and tracking tools to support consistency and audit readiness
Support capacity planning, reporting, and trend analysis to drive operational awareness and decision-making
Use data and claim findings to recommend solutions, improve processes, and support long-term operational effectiveness