Medicare Par Provider Appeals and Non-Par Claim Disputes Quality Analy

United Health Group
Sep 22, 2016
Oct 20, 2016
Employer Type
Direct Employer
Employment Type
Full Time
Job Responsibilities:

Welcome to one of the toughest andmost fulfilling ways to help people, including yourself. We offer the latesttools, most intensive training program in the industry and nearly limitlessopportunities for advancement. Join us and start doing your life's bestwork.SM

Flexible, Friendly, Fast on yourfeet, that's a great start. Accurate, Accountable, Self Directed, These traitscan take you places. Our claims operations are the focal point of handlinginformation about services patients receive and the way those services getpaid. It's complex, detailed work. It's fast paced challenge. It's a job thatcalls on you to be thoughtful, resourceful, team-driven and customer-focused.To put it mildly, there is never a dull moment. Claims Quality Analysts are responsible for all aspects of qualityassurance within the Claims job family. Conduct audits and provide feedback toreduce errors and improve processes and performance.

Primary Responsibilities:

* Provide claims support byreviewing, researching, investigating, auditing claims
* Provide feedback to team memberson audit results
* Analyze and identify trends andprovide feedback and reports to reduce errors and improve claims processes andperformance
* Responsible for all aspects ofquality assurance
* Analyze information and utilize tobuild recommendations to reduce errors and improve process performance
* Create, maintain and track reportsin relation to performance
* Serve as subject matter resourceto team members, supervisors and management staff


* High School Diploma or GED
* 1+ years of experience researching and/or processing claims using the COSMOS claims platform
* 5+ years of Medicare claims processing experience
* 3+ years of Medicare claims research and adjustment experience
* Knowledge of Medicare and internal UHC claims processing requirements


* Undergraduate Degree or higher
* 3+ years working experience in claims processing or quality

Physical Requirements and Work Environment:

* Extended periods of sitting at a computer and use of hands/fingers across keyboard or mouse
* Office environment

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 14 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can 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.

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