Flexible? Friendly? Fast on your feet? That's a great start. Accurate? Accountable? Self Directed? These traits can take you places. Our claims operations are the focal point of handling information about services patients receive and they way those services get paid. It's complex, detailed work. It's fast paced challenge. It's a job that calls on you to be thoughtful, resourceful, team-driven and customer-focused. To put it mildly, there is never a dull moment.

 Primary Responsibilities:

• Provide expertise claims support by reviewing, researching, investigating, negotiating and resolving all types of claims as well as recovery and resolution for health plans, commercial customers and government entities.
• Analyze and identify trends and provides reports as necessary
• Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance
• Extensive work experience, possibly in multiple functions.
• Work does not usually require established procedures.
• Works independently.
• Mentors others.
• Acts as a resource for others.
• Coordinates others' activities.
  

• High School Diploma/GED is required
• 2+ years of healthcare experience; i.e. someone who has worked within a healthcare environment and is familiar with the terminology
• Medical Insurance background is required
• 1+ year of customer service experience; i.e. analyzing and solving customer problems
•  Intermediate level of proficiency with MS Excel, i.e. sorting/filtering, creating spreadsheets, data manipulations, etc.

Assets:

• Knowledge of UNET, COSMOS, and/or NICE is preferred
• 1+ year of experience in medical claims and/or adjustments
• 2+ years of experience within an Collector role; i.e. someone who has previously or is currently working within a collector capacity
• Customer service experience in a healthcare and/or call center environment is preferred

OptumInsight is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.

OptumInsight is one of the largest and fastest growing health information companies. We specialize in improving the performance of the health system by providing analytics, technology and consulting services that enable better decisions and results. We integrate workflow solutions that deliver data in real-time, and create actionable insights - processing health information that relates directly to and affects one in four patients in the U.S, one in every three Medicaid dollars and one in every five emergency room visits. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.

What can YOU do with the right information? At OptumInsight, the possibilities and the impact are limitless. No matter what your role is at OptumInsight, you'll be empowered to ask more questions, develop better solutions and help make the health care system greater than ever. It's always fresh. It's always exciting. And it's never been more important.

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.