Senior Provider Service Representative - Schaumburg, IL

Unitedhealth Group Inc. Schaumburg , IL 60196

Posted 2 days ago

Energizeyour career with one of Healthcare's fastest growing companies.

Youdream of a great career with a great company where you can make an impact andhelp people. We dream of giving you theopportunity to do just this. And withthe incredible growth of our business, it's a dream that definitely can cometrue. Already one of the world's leading Healthcare companies, UnitedHealthGroup is restlessly pursuing new ways to operate our service centers, improveour service levels and help people lead healthier lives. We live for the opportunity to make adifference and right now, we are living it up.

Thisopportunity is with one of our most exciting business areas: Optum a growingpart of our family of companies that make UnitedHealth Group a Fortune 6 leader.

Optum helps nearly 60million Americans live their lives to the fullest by educating them about theirsymptoms, conditions and treatments; helping them to navigate the system,finance their healthcare needs and stay on track with their health goals. Noother business touches so many lives in such a positive way. And we do it allwith every action focused on our shared values of Integrity, Compassion,Relationships, Innovation & Performance.

Get ready for some significant challenge. You'll ensure provider service quality by working with them to resolve issues, deliver educational materials and contribute to projects that enhance overall operational effectiveness.

Challenge can often be its own reward. But why settle for just being challenged when you can also be nurtured, mentored and supported in building an impactful and fast paced career? With UnitedHealth Group you can have all of the above every day. UnitedHealth Group is driving even higher levels of sophistication in how provider networks are formed and operate. The goal is to improve quality of service while exploring new ways to manage costs. Here's where you come in. You'll use your knowledge of insurance claims and customer service to help create strong relationships with the providers in our networks. As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 6 leader.

Primary Responsibilities:

  • Actively Audit Medicare Pharmacy Claims

  • Claim and documentation review

  • Involved in Pharmacy interface

  • Working with data and analytics

  • Identifying trends in data

  • Updating processes as needed with the changing landscape of Medicare

  • Assist with training of new hires and train current employees on new processes

  • Working on various projects / reports

  • Additional duties

Required Qualifications:

  • High School Diploma / GED (or higher)

  • State of IL Pharm Tech License

  • National Pharm Tech Certification

  • Experience with Microsoft Excel (pivot tables, vlookups)

  • Experience with data analytics (reviewing data and being able to identify trends)

  • Knowledge of Medicare

OptumRx is an empowering place for people with the flexibility to help create change. Innovation is part of the job description. And passion for improving the lives of our customers is a motivating factor in everything we do.

If you're ready to talk about groundbreaking interactions, let's talk about what happens when a firm that touches millions of lives decides to gather results from millions of prescriptions every month and analyze their impact. Let's talk about smart, motivated teams. Let's talk about more effective and affordable healthcare solutions. This is caring. This is great chemistry. This is the way to make a difference. We're doing all this, and more, through a greater dedication to our shared values of integrity, compassion, relationships, innovation and performance. Join us and start doing your life's best work.

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: Audit, Data, Analytics, Pharm Tech, Certified Tech, Medicare OptumRx


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Senior Provider Service Representative - Schaumburg, IL

Unitedhealth Group Inc.