Claims Clerk - Lawrenceville, IL

Unitedhealth Group Inc. Lawrenceville , IL 62439

Posted 3 months ago

Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.

The Claims Clerk is responsible for providing expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting claims.

Primary Responsibilities:

  • Provide general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims

  • Authorize the appropriate payment or refers claims to investigators for further review

  • Conduct data entry and re - work; analyzes and identifies trends and provides reports as necessary

  • Analyze and identify trends and provide reports as necessary

  • Consistently meet established productivity, schedule adherence, and quality standards

  • Recognize claims by determining claim type

  • HCFA, Hospital, UB, and / or RX
  • Identify more complicated claims and refer them to Senior Claim Processor or Supervisor

  • Calculate other insurance and re - pricing benefits

  • Work claims files to ensure the appropriate eligibility and provider records are matched to the claim

  • Update and maintain claims tracking database

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.

Required Qualifications:

  • High School Diploma / GED (or higher)

  • 1 year of experience in an Office setting environment using the computer as the primary instruments to perform job duties

  • 1 years of experience in numeric 10 - key / keyboarding experience

  • Intermediate proficiency with computer and Windows PC

  • Ability to work 8 hr shifts Monday Friday between 6:30 am

  • 5:00 pm

Preferred Qualifications:

  • 1 years of experience working with Medical claims

  • 1 years working in production - based environment

  • Basic understanding of Healthcare claims including ICD - 10 and CPT codes

Soft Skills:

  • Ability to work well with a team and maintain a positive attitude

  • Adaptable to rapidly changing work environment

  • Ability to be flexible and open to new ideas

Physical and Work Environment:

  • Ability to work in a dynamic environment, both independently and in a group setting

  • Prolonged periods of sitting at desk/computer using hands/fingers across keyboard or mouse

Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.SM

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Keywords: Claims, Processing, Clerk, Authorize, Analyze


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Claims Clerk - Lawrenceville, IL

Unitedhealth Group Inc.