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 Senior Claims Representative - Tampa, FL - Tampa, Florida, United States

   
Job information
Posted by: UnitedHealth Group 
Hiring entity type: Insurance 
Work authorization: Existing work authorization required for United States
Position type: Direct Hire, Full-Time 
Compensation: ******
Benefits: See below
Relocation: Not specified 
Position functions: Administrative - Financial Processing
Administrative - Other
Customer service & support
Insurance
 
Travel: Unspecified 
Accept candidates: from anywhere 
Languages: English - Fluent
 
Minimum education: See below 
Minimum years experience: See below 
Resumes accepted in: English
Cover letter: No cover letter requested
Job code: 523581 / Latpro-2498113 
Date posted: Jun-05-2013
State, Zip: Florida, 33606

Description

Position Description:

 

United Healthcare International Global Solutions is an innovative program is designed to help U.S.-based employers achieve the highest level of expatriate success by ensuring a seamless, successful experience for employees and their families as they relocate overseas.  Our team of multi-lingual professionals, located in Tampa, FL, is caring, innovative and provides decisive personalized service to members, providers, plan sponsors, brokers and vendors 24 hours a day, seven days a week, 365 days a year.  Now is the time to apply for this exciting position within United Healthcare International Global Solutions.
 

The Medical Claims Representative is responsible for the accurate processing and completion of US and International medical claims.

 
Primary Responsibilities:

  • Process claims that route out of automatic adjudication, within current turnaround standards 
  • Ability to understand and apply plan concepts to include:
    • Deductible
    • Coinsurance
    • Copay
    • Out-of-pocket
    • State variations
  • Provide expertise or general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims
  • Recognize issues related to variable deductible, coordination of benefits; carve-out alternate benefits.
  • Authorize appropriate payment or refer claims to investigators for further review
  • Analyze and identify trends and provides reports as necessary
  • Consistently meet established productivity, schedule adherence, and quality standards
  • Provide excellent customer service
  • Benefit Plan Set-up Testing




Requirements

Requirements:

  • An education level of at least a high school diploma or GED
  • 2+ years of US Healthcare Insurance, medical claims adjudication experience is required
  • Intermediate proficiency with MS Word, MS Excel and professional email required
  • Previous experience working in the healthcare industry is required
  • Must be able to work occasional overtime as business needs require

Assets:

    • All bi-lingual language skills are a plus
    • Experience with UNET platform is preferred

Physical Requirements and Work Environment:
  • Extended periods of sitting at a computer and use of hands/fingers across keyboard or mouse
  • Office environment

UnitedHealth Group is working to create the health care system of tomorrow.

Already Fortune 25, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.

Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant - and built for speed.

Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams.

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.


 

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