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Senior Recovery / Resolution Analyst - Eden Prairie, MN Or Telecommute

Expired Job

Unitedhealth Group Inc. Eden Prairie , MN 55344

Posted 4 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.(sm)

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.

Investigate Optum Waste and Error stopped claims by gathering information, researching state and federal guidelines, and following internal procedure to determine the viability of the claim for further review in a production environment.

Primary Responsibilities:

  • Clinical Inventory Management-75%

  • Review medical records to determine if the claim is supported or unsupported

  • Provide clear and concise clinical logic to the providers when necessary

  • Other internal customer correspondence and team needs 15%

  • 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

  • Continue education 10%

  • Keep up required Coding Certificate and/or Nursing Licensure

  • Complete compliance hours as required by the department

Required Qualifications:

  • 2 years of experience in Optum Waste and Error policies and procedures

  • Working knowledge of the healthcare insurance/managed care industry

  • Previous experience in claim processing, healthcare provider information and healthcare billing practices

  • Working knowledge of medical terminology and claim coding

  • Strong written and verbal communications skills

  • Strong customer service skills

  • Ability to work in a team

  • Proficient with personal computers, including Microsoft Suite of products

  • Required Coding Certificate or Nursing Licensure, for example

  • Certified Inpatient Coder (CIC)

  • Certified Outpatient Auditor (COC)

  • Certified Professional Medical Auditor (CPMA)

  • Certified Coding Specialist (CCS)

Preferred Qualifications:

  • Strong analytical and problem solving skills

  • Previous presentation or policy documentation experience

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do 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.

Job Keywords: clinical inventory management, customer correspondence, coding, healthcare, insurance, medical, customer service, Eden Prairie, MN, Minnesota, telecommute, telecommuting, remote, work from home


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Senior Recovery / Resolution Analyst - Eden Prairie, MN Or Telecommute

Expired Job

Unitedhealth Group Inc.