Healthcare EDI Coordinator - Ontario, CA

Unitedhealth Group Inc. Ontario , CA 91761

Posted 7 months ago

Imagine this. Everyday, in claims centers around the world, UnitedHealth Group is processing and resolving payment information for millions of transactions. Would you think we have some great technology? Would you think we know how to manage volume? You would be right. No one's better. And no company has put together better teams of passionate, energetic and all out brilliant Claims Representatives. This is where you come in. We'll look to you to maintain our reputation for service, accuracy and a positive claims experience. We'll back you with great training, support and opportunities.

Primary Responsibilities:

  • Identify and resolve new or unusual EDI claims errors/issues as they arise, using established procedures

  • Achieve applicable performance metrics (e.g., productivity, quality, TAT)

  • Use appropriate documentation, reference materials and/or websites to ensure that EDI claims are processed accurately and efficiently

  • Collaborate with operational partners to help complete claims processing workflows

  • Generate and distribute reports as required

  • Learn and use new systems/applications/resources as needed

  • Comply with Applicable Laws, Regulations and Policies

  • Ability to apply knowledge/skills to basic, repeated activities.

  • Knowledge of UB04 and CMS1500 claim form layouts

  • Ability to carry out assignments with thoroughness, accuracy and attention to detail.

  • Strong organization and prioritization skills

  • Respond in a timely manner to customer requests and concerns

  • Ability to make logical fact-based decisions

Required Qualifications:

  • High school diploma or GED 1 year of equivalent working experience

  • 1 years of experience in a related environment (i.e. office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools

  • Basic Moderate Proficiency. Outlook, Excel and Word

Preferred Qualifications:

  • Ability to understand multiple processing rules to ensure timely delivery for transactions

OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare's support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.

North American Medical Management, California, Inc. (NAMM) develops and manages clinician networks, offering a full range of services to assist physicians and other clinicians in their managed care and business operations. For over 17 years, NAMM has been an innovator in health care with a track record for quality, financial stability, extraordinary services and superior electronic capabilities. Prime Care Medical Network is a key affiliate.

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

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

Job Keywords: Healthcare EDI Coordinator, Ontario, CA, California


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Healthcare EDI Coordinator - Ontario, CA

Unitedhealth Group Inc.