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Provider Reimbursement Specialist

UnitedHealth Group

UnitedHealth Group

Provider Reimbursement Specialist

National
Full Time
Paid
  • Responsibilities

    If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Financial discipline and accountability count more today than ever. Which is why your performance and innovation will find a reception here like nowhere else as you help people live healthier lives while doing your life's best work. The statements listed below are not intended to be all inclusive of the duties and responsibilities of the position. Based on leadership decisions and business needs, "ALL OTHER DUTIES AS ASSIGNED" will be expected for each position. Review and approve provider invoices in an accurate, efficient, and timely manner to maintain good working relationships between LHI and network providers. Investigate any discrepancies found on provider invoices and communicate with the network providers to resolve the issue.

    PRIMARY RESPONSIBILITIES:

    • Review and approve provider claims in an accurate, efficient, and timely manner to maintain good working relationships between LHI and network providers. Match claims received to LHI orders, verify amount billed versus contracted rates, review order status, and review provider fee schedules for confirmation of rates and terms.
    • Investigate any discrepancies, balance forwards, or aged claims, and communicate with providers to resolve the issue.
    • Field incoming calls from providers and internal departments to provide payment details, explanation of payment, and more. Determine if follow up communication is needed.
    • Understand LHI contracts and terms to ensure timely and accurate payments to providers.

    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.

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  • Qualifications

    REQUIRED QUALIFICATIONS:

    • 1+ years related accounting experience
    • High School Diploma/GED or higher

    PREFERRED QUALIFICATIONS:

    • Associate's Degree in Accounting related field
    • National Career Readiness Certificate

    CAREERS WITH LHI. Our focus is simple. We're innovators in cost-effective health care management. And when you join our team, you'll be a partner in impacting the lives of our customers, and employees. We've joined OptumHealth, part of the UnitedHealth Group family of companies, and our mission is to help the health system work better for everyone. We're located on the banks of the beautiful Mississippi River in La Crosse, Wis., with a satellite office in Chicago and remote employees throughout the United States. We're supported by a national network of more than 25,000 medical and dental providers. Simply put, together we work toward a healthier tomorrow for everyone. Our team members are selected for their dedication and mission-driven focus. For you, that means one incredible team 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.

  • Industry
    Hospital and Health Care
  • Fun Fact
    UnitedHealth Group is working to create the health care system of tomorrow.
  • About Us

    A Fortune 6 company, we're focused on helping people live healthier lives while making the health system work better for everyone. Here, we seek to empower people with the information, guidance and tools to make personal health choices. We work harder and we aim higher. We expect more from ourselves and each other. And, at the end of the day, we’re doing a lot of good for more than 142 million people worldwide.