Claims Clerk - National Remote

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life’s best work.SM

The Claims Clerk is responsible for providing expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting claims.

This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 6:30am-9pm CST. It may be necessary, given the business need, to work occasional overtime.

We offer 6-8 weeks of on-the-job / shadow based training. The hours during training will be 8:00am to 4:30pm CST, Monday - Friday. Duration for training is based on the individual candidate and their needs. More details on the training will be discussed further during the interview process by the hiring manager.

• All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary Responsibilities:

• Provide general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims.
• Authorize the appropriate payment or refers claims to investigators for further review.
• Conduct data entry and re-work; analyzes and identifies trends and provides reports as necessary.
• Analyze and identify trends and provide reports as necessary
• Consistently meet established productivity, schedule adherence, and quality standards
• Recognize claims by determining claim type - HCFA, Hospital, UB, and/or RX
• Identify more complicated claims and refer them to Senior Claim Processor or Supervisor
• Calculate other insurance and re-pricing benefits
• Work claims files to ensure the appropriate eligibility and provider records are matched to the claim
• Updates and maintains claims tracking database

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• High School Diploma / GED OR equivalent work experience
• 2+ years of data entry experience
• 2+ years experience with Microsoft Excel and Microsoft Outlook, including the ability to create, edit, save and send documents, spreadsheets and correspondence
• 1+ years of experience in an office setting environment using the telephone and computer as the primary instruments to perform job duties
• Basic proficiency with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
• Must be 18 years of age OR older
• Ability to work 6:30am - 9:00pm CST. It may be necessary, given the business need, to work occasional overtime.

Preferred Qualifications:

• 1+ years of experience working with medical claims
• 1+ years of working in production based environment
• Ability to type 60+ WPM
• Prior experience working with IDX software
• Basic understanding of healthcare claims including ICD-10 and CPT codes

Telecommuting Requirements:

• Ability to keep all company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Washington or Rhode Island Residents Only: The hourly range for California / Colorado / Connecticut / Hawaii / Nevada / New York / New Jersey / Washington / Rhode Island residents is $16.00 - $23.94 per hour. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

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.

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