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Senior Recovery Resolutions Representative - Huntsville, AL - Full-time / Part-time
| Hours | Full-time, Part-time |
|---|---|
| Location | Birmingham, AL Birmingham, Alabama |
About this job
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.
Welcome
to 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.
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.
This employee will be working as the only onsite person at Community Health Systems to better manage this client.
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.
Requirements
Requirements:
- An education level of at least a high school diploma/ GED OR 10 years of equivalent working experience is required
- 1+ years of Client facing/ interaction experience and/ or working onsite at a client site
- 1+ years experience in a position that requires math calculations and deriving percentages from data quickly
- Intermediate level of MS Excel with the ability to work with large amounts of data is required
- Intermediate proficiency with MS Outlook computer and Windows PC applications
- Travel locally up to 25%
Assets:
- Bachelor's Degree preferred
- Prior Claims Adjudication experience
- Experience working in an operations/ production based environment
- Healthcare industry experience
Physical Requirements and Work Environment:
- Extended periods of sitting at a computer and use of hands/ fingers across keyboard or mouse
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.
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.
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