YOU’LL ENJOY THE FLEXIBILITY TO TELECOMMUTE* FROM ANYWHERE WITHIN THE U.S. AS YOU TAKE ON SOME TOUGH CHALLENGES.

The health care system is still evolving at a rapid pace. Technology is driving new advances in how patient care is delivered and how it's reimbursed. Now, UNITEDHEALTH GROUP invites you to help us build a more accurate and precise approach to claims adjudication. In this role, you'll be responsible for all aspects of quality assurance within the claims job family including conducting audits and providing feedback to reduce errors and improve processes and performance. Join us and build your career with an industry leader.

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 8:00am - 5:00pm. It may be necessary, given the business need, to work occasional overtime.

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

PRIMARY RESPONSIBILITIES

• Refine Medical Claim Review quality auditing procedures.
• Provide constructive auditing feedback to the MCR staff.
• Partner with MCR Management Team to provide effective and efficient MCR recommendations.
• Promote and support MCR business objectives.
• Interface with Medical Directors, nurses and other claim associates.
• Contribute to or lead as needed, quality improvement projects

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 or GED or equivalent years of work experience
• 3+ years of working experience in claims processing or quality
• Moderate proficiency with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications
• Experience with Microsoft Word (Create and Edit documents), Microsoft Excel (data entry and sorting) and Microsoft Outlook

Preferred Qualifications:

• Active LPN/LVN license in current state of residence
• Knowledge of procedural coding (ICD - 10, Revenue codes)
• 3+ years of MCR (Medical Claims Review) experience
• MCR 30D Readmission review, UMR, C&S, and/or M&R review experience
• Familiarity with claim processing and related systems (COSMOS/CPA, NICE, CSP Facets, CPS Facets)

TELECOMMUTING REQUIREMENTS:

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

SOFT SKILLS

• Strong organizational skills
• Strong team player
• Ability to deliver constructive feedback
• Ability to multi-task, this includes the ability to understand multiple products and multiple levels of benefits within each product
• Must be able to work independently and demonstrate initiative
• Must be comfortable working in a high performing team environment
• Must be able to meet strict deadlines
• Must possess excellent oral and written communication skills

UNITEDHEALTH GROUP REQUIRES ALL NEW HIRES AND EMPLOYEES TO REPORT THEIR COVID-19 VACCINATION STATUS.

MILITARY & VETERANS FIND YOUR NEXT MISSION: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at https://uhg.hr/transitioning-military

Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible. https://uhg.hr/vet

OPTUM 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.

At OPTUM, you will perform within an innovative culture that's focused on transformational change in the Healthcare system. You will leverage your skills across a diverse and multifaceted business. And you will make contributions that will have an impact that's greater than you've ever imagined. What can YOU do with the right information? At Optum, the possibilities and the impact are limitless. No matter what your role is at Optum, you'll be empowered to ask more questions, develop better solutions and help make the health care system greater than ever. It's always fresh. It's always exciting. And it's never been more important.

Colorado Residents Only: The hourly range for Colorado residents is $20.77 to $36.88. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary,  UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

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.

Keywords: UHG, Optum, review, research, technician, claims, analyst, telecommute, OptimaHealth, work at home, work from home, WAH, WFH, remote, telecommute, hiring immediately, #RPO

[]