Provider Issue Resolution Specialist - Richardson, TX - Full-time / Part-time

Energize your career with one of health care's fastest growing companies.  

You dream of a great career with a great company where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it's a dream that definitely can come true. Already one of the world's leading health care companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.


The Provider Issue Resolution Specialist (PIRS) is responsible for efficiently navigating claim processing systems to complete all closed and denied, simple adjustments, and the majority of complex adjustments (out of scope high dollar and inpatient).  Also, the PIRS will provide quality service to our Providers through real time and accurate resolution of closed and denied claims, simple adjustments and escalated claim issues.

Responsibilities:

• Perform all types of complex adjustments and closed, denied, and simple adjustments 
• Meet Quality, Productivity and Attendance requirements
• Ensure Provider Satisfaction through:
• Maintaining accurate documentation in ORS
• Providing assistance to Providers with status updates
• Being responsible for any follow-up work needed for resolving and closing issues
• Identifying and resolving anticipated Provider issues to prevent future calls
• Maintain proficiency in all technical applications (technical skills and system knowledge)
• Comply with all current policies, procedures and workflows

Qualifications:

• 2 years of Claims, Office, or Customer Service experience analyzing and solving customer problems
• Knowledge of medical claims billing ICD9, CPT, or HCPC codes
• An education level of at least a high school diploma or GED OR 10 years of equivalent working experience
• Authorization to work in the United States
• Familiarity with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
• Ability to remain focused and productive each day though tasks may be repetitive
• Effective communication skills

Work Environment:

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

UnitedHealth Group is working to create the health care system of tomorrow and you can help. Already Fortune 17, we are totally focused on innovation and change.  We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.

Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant and built for speed.  Join with us and start doing your life's best work. SM

Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.