Sr. Recovery Resolutions Analyst for M&R Clinical Waste and Error - US

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

Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.

The Sr. Recovery Resolutions Analyst for M&R Clinical Waste and Error will work with a team on researching physician medical records to ensure correct coding of medical claims.

Primary Responsibilities:

* Review medical records to identify appropriate coding based on CMS requirements
* Investigate all types of professional claims to identify savings for our customers
* Ensure adherence to state and federal compliance policies, reimbursement policies, and contract compliance
* Monitor coding changes to ensure that most current information is utilized.
* Adhere to turn around time and standards
* Meet and maintain minimum quality and productivity standards
* Acts as a resource for others


* High school diploma or GED
* Must possess a current Coding Certification CPC, CPMA, CEMC, CCS-P, RHIT, or a current license as an RN or LPN
* 4+ years of experience in provider or facility setting coding CPT/HCPCS/ICD-10, including knowledge of industry terminology and regulatory guidelines.
* Ability to create and modify spreadsheets within MS Excel
* Ability to create and modify documents within MS Word
* Ability to create, manage, and organize email and calendar within MS Outlook
* Knowledge of claims processing systems and guidelines/processes


* Knowledge of Medicaid/Medicare Reimbursement methodologies
* Knowledge of Encoder systems

Soft Skills:

* Excellent written and verbal communication skills
* Strong collaboration and relationship building skills

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to 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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