Senior Recovery Resolution Analyst

UnitedHealth Group•Minneapolis, MN

5d•$29 - $52•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 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 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 (40hours/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 – 5:00pm. It may be necessary, given the business need, to work occasional overtime. We offer weeks of on-the-job training. The hours of the training will be aligned with your schedule. 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
Certified Coding Specialist (CCS), OR Certified Professional Coder (CPC)
Must be 18 years of age OR older
Working knowledge of medical terminology and claim coding.
Knowledge of claims processing systems and guidelines/processes
Experience with Microsoft Excel (create, edit, sort, filter)
Ability to work full-time (40hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm. It may be necessary, given the business need, to work occasional overtime.

Nice To Haves

1+ years of Medical record coding experience with experience in Evaluation and Management Services in the professional setting.
Knowledge of Medicaid/Medicare Reimbursement methodologies
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 clinical review of professional claims vs. medical records to determine if the claim is supported or unsupported.
Maintain standards for productivity and accuracy.
Provide clear and concise clinical logic to the providers when necessary.
Attend and provide feedback during monthly meetings with assigned internal customer department.
Provide continuous feedback on how to improve the department relationships with internal team members and departments.
Keep up required Coding Certificate
Complete compliance hours as required by the department.