Senior Recovery - Resolutions Analyst - Murrieta, CA and surrounding Inland Empire area facilities

Position Description:

Energize your career with one of Healthcare'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 Healthcare 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.

This opportunity is with one of our most exciting business areas: Optum –a growing part of our family of companies that make UnitedHealth Group a Fortune 17 leader.

Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.

UnitedHealth Group is working to create the health care system of tomorrow.

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.

Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams.

The Senior Recovery Resolution Representative handles information about patient services and how those services are paid by investigating and pursuing recoveries through contact with various parties. The representative manages subrogation files, negotiates settlements, and ensures adherence to compliance policies.

Positions in this function are responsible for investigating, recovering and resolving all types of claims as well as recovery and resolution for health plans, commercial customers and government entities. May include initiating telephone calls to members, providers and other insurance companies to gather coordination of benefits data. Investigate and pursue recoveries and payables on subrogation claims and file management. Process recovery on claims. Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance. May conduct contestable investigations to review medical history. May monitor large claims including transplant cases.

Primary Responsibilities:

• Provide claims expertise support by reviewing, researching, investigating, negotiating, and resolving all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities


• Analyze, identify trends, and provide reports as necessary


• Ensure adherence to state and federal compliance policies, reimbursement policies, and contract compliance


• Manage subrogation files


• Perform other duties as assigned


• Extensive work experience, possibly in multiple functions.


• Work does not usually require established procedures.


• Works independently.


• Mentors others.


• Acts as a resource for others.


• Coordinates others' activities.

Working Location:

UHS –
Pacific: 38977 Sky Canyon Dr, Murrieta CA 92563 and surrounding Inland Empire
area facilities

Requirements:

• High School Diploma or GED


• 2 years of claims or collections experience (prefer in a face to face setting and healthcare industry)


• 1+ years of Customer Service experience (ability to build and maintain rapport, prefer in a face to face setting and healthcare industry)


• Experience working in the healthcare industry billing/coding/recovery/collection


• Proficiency with computer and Windows PC applications; Word, Excel, Outlook


• Travel 25% of the time; training in Tennessee and then within local communities


• Strong communication skills (both written and verbal, via the phone, computer, and face to face)


• Experience in analyzing data and creating action plans based on that data, utilizing strong problem solving skills


• Experience working high stress goals within timelines and manage time effectively

Assets:

• Accounting experience


• Bachelor's degree preferred


• Experience in claims recovery and resolution


• Experience working with subrogation


• Experience with negotiations

Physical Requirements and Work Environment:

• Frequent speaking, listening using a headset, sitting, use of hands/fingers across keyboard or mouse, handling other objects, long periods working at a computer


• Service center environment with moderate noise level due to Representatives talking, computers, printers, and floor activity

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care 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.

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.