Senior Claims Business Process Analyst

UnitedHealth Group•Tampa, FL

5h•$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. For all hires in Minneapolis, Virginia, Maryland, or Washington, D.C. area, you will be required to work in the office for a minimum of four (4) days per week. At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together Senior Claims Business Process Analyst: This position will be assigned to ClearHealth Strategies’ Independent Dispute Resolution (“IDR”) team. You will work with the IDR team in a quasi-legal process to assist in the review of disputes, eligibility analysis, and preparation of arbitration briefs in support of ClearHealth’s compliance with the federal No Surprises Act and state surprise billing laws. Using available state and federal guidelines, you will be an essential contributor throughout the IDR process, with focus on briefing and submission of documentation to an independent arbiter. You will be expected to cogently respond to requests from CMS, independent arbiters, providers, clients, management, and other individuals throughout the day. Candidate should have the ability to work independently and follow defined standards and procedures with efficiency and accuracy. This position is full-time (40 hours/week) Monday - Friday. Employees are required to work an 8-hour shift schedule during our normal business hours of 8:00 am - 5:00 pm depending local time zone. It may be necessary, given the business need, to work occasional overtime. 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 OR equivalent work experience
Must be 18 years of age OR older
2 + years of legal experience either in a law firm or in-house legal department.
Experience ensuring compliance with HIPAA privacy and security regulations
Ability to work full-time between 8:00 am - 5:00 pm local time, including the flexibility to work occasional overtime given the business need
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.

Nice To Haves

1+ years of experience in the federal No Surprises Act (NSA) and/or state surprise billing disputes
Insurance claims, medical billing and/or health insurance industry experience
Experience in Personal injury litigation
Knowledge of medical claims process

Responsibilities

Prepare arbitration briefs
Respond to inquiries from CMS, arbiters, providers, clients, and ClearHealth management
Identify issues, analyze EOBs and claims information, apply critical thinking skills to formulate plan of action, and resolve issues independently
Triage complex issues to management
Manage multiple priorities in a time sensitive manner
Work in fast-paced, high-volume environment with quick turnaround time
Communicate effectively utilizing solid business writing skills
Prioritize and manage workload to meet deadlines, goals, and objectives
Collaborate with coworkers in cohesive team environment
Ready to work, ready to learn mindset
Integrity, accountability, and ability to maintain confidentiality