Senior Employer Installation Admin - US Telecommute

United Health Group
Oct 13, 2016
Oct 26, 2016
Employer Type
Direct Employer
Employment Type
Full Time
Position Description:

Working in Operations at UnitedHealth Group is 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.SM

This position is responsible for confirming the accuracy of new provider contract and amendment configuration, the set up of benefit packages and authorization rules, verifying claim system edits and third party tools, and validating key system support tables. This includes developing and executing efficient and effective test plans for physician, institutional, and ancillary provider contract installation; member benefit package configuration; system claim edits and third party tools, and system migrations, releases, and/or enhancements.

Positions in this function are responsible for the installation of assigned accounts, including, but not limited to: structure building and billing set up, structure revisions, researching and resolving structure issues, database loading, and preparation of plan materials such as administrative documents and customer education materials. Senior Employer installation Admins are responsible for overall employer contract loading using various databases and/or source documents. May research installation issues and develop customer specific resolutions. May include auditing contract loads for adherence to quality measures and reporting standards.

Primary Responsibilities:

* Overall employer contract loading and using various databases and/or source documents
* Research Installation Issues and develop customer specific resolution
* Audit contract loads for adherence to quality measures and reporting standards.
* Reviews the work of others.
* Develops innovative approaches.
* Sought out as expert.
* Serves as a leader/mentor.

Required Qualifications:

* High School Diploma/GED is required
* 3+ years of direct experience with Healthcare Professional and Institutional Claims; i.e. someone who is familiar with Physician's Healthcare Claims and Contract Terms, Facility Claims, Interpreting Contracts and Fee Schedules and understanding Basic Payment Processes (i.e. provider specialties), etc.
* 3+ years of experience with MS Word, Excel, and Outlook or similar tool (Word - creating basic documents; Excel - managing data in Excel spreadsheets, creating pivot tables, developing macros, etc.; Outlook or similar tool - emailing, calendaring, scheduling etc.)
* 3+ years of demonstrated Contract Configuration audit experience; i.e. worked with Interpreting and Translating Contracts into test cases using Healthcare Claims Set-up, ability to read Business Requirement Documents, Fee Schedules, etc.
* 3+ years of Inventory Management experience; i.e. looking at Daily Inventory Reports and Triage and report work and make sure it's assigned out properly

Preferred Qualifications:

* Experience with FACETS is a plus
* SQL experience is a plus
* Knowledge of Business Operations
* Knowledge of Medicare/Medicaid State Regulatory Requirements
* Training experience

Soft Skills:

* Demonstrated leadership skills; i.e. presenting information to senior levels of management

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 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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