UnitedHealth Group is among the most ambitious Fortune 25 companies you'll ever meet. Through our family of businesses, we're working to make the health care system perform better for more people, in more ways than ever.
Simply put, we think the entire system can be greater than it's ever been. And that drives us to work harder, aim higher, and expect more from one another.
Here, you'll be empowered to make an immediate impact for millions of others. And you'll achieve more than you ever expected. How does that fit with your plans?
Claims Representative Associate - Irvine, CA-313724
UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.
Description
Prescription Solutions 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.
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 pharmacy teams. Let's talk about more effective and affordable health care solutions. This is caring. This is great chemistry. This is the way to make a difference.
Claims Representative Associate - Irvine, CA
Position Description:
Positions in this function are responsible for providing expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting claims.
Primary Responsibilities:
- Authorize the appropriate payment or refer claims to investigators for further review
- Conduct data entry and re-work; analyze and identify trends and provides reports as necessary
- Accurate processing and completion of pharmaceutical claims upon first receipt
- Process somewhat complex claims within current turnaround standards including:
- Claims requiring COB/Medicare
- Claims requiring application of plan specific Special Processing Instructions (SPIs)
- Access systems to obtain information that will assist in claims resolution
- Special projects as required
- Adhere to quality improvement initiatives
- Adhere to daily quantity production standards
- Use pre-approved electronic letters to communicate with customers
Prescription Solutions is an empowering place for people with the flexibility to help create change. Innovation is part of the job description. New ideas are welcome. And passion for improving the lives of our customers is a motivating factor in everything that happens.
Qualifications
Qualifications:
- 1 or more year(s) experience in Claims Processing is required
- Payment Posting, Collections (Healthcare Insurance field), Billing (Healthcare Insurance field), Pharmacy Technician are strongly preferred
- 10-Key by touch is required
- Typing 35 WPM is required
- Needs to be self motivated
- Knowledge of MS Word and MS Excel
- Must have the ability to work in a fast paced environment
- Attention to detail, Quality focused
- Must maintain a positive attitude
- Strong written and communication skills
- Must posses sound decision-making skills
- Must posses excellent organization skills
- Must be a team player
- High school education or equivalent experience
- Required testing: typing test and 10 key by touch
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.
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. |
