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Claims Business Process Analyst - Eau Claire, WI - Full-time / Part-time
| Hours | Full-time, Part-time |
|---|---|
| Location | Eau Claire, WI Eau Claire, Wisconsin |
About this job
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.
Flexible, Friendly, Fast on your feet, that's a great start. Accurate, Accountable, Self Directed, These traits can take you places. Our claims operations are the focal point of handling information about services patients receive and they way those services get paid. It's complex, detailed work. It's fast paced challenge. It's a job that calls on you to be thoughtful, resourceful, team-driven and customer-focused. To put it mildly, there is never a dull moment. Senior Claims Business Process Analysts are responsible for all related aspects of claim system processes and claim business rules. Include claims systems utilization, capacity analyses/planning and reporting, claims-related business and systems analysis. Ensure data integrity, data security and process optimization.
Primary Responsibilities:
- Responsible for providing research and root cause analysis for claim quality remediation
- Perform capacity planning and reporting
- Responsible for all aspects of quality assurance
- Create and edit requirements, specifications, cost benefit analysis and recommendations to proposed solutions
- Facilitate development of process documentation
- Follow standard programming guidelines and requirements as set by team
- Standard documentation and tracking processes
- Uses pertinent data and facts to identify and solve a range of problems within area of expertise
- Responsible for all related aspects of claim system processes and claim business rules. Includes claims systems utilization, capacity analyses/planning and reporting. Includes claims-related business and systems analysis.
- Ensures data integrity, data security and process optimization.
- Analyzes and investigates.
- Provides explanations and interpretations within area of expertise.
Requirements
Requirements:
- High School Diploma or GED
- 2+ years of experience analyzing and solving customer problems in an office setting environment
- Experience working in teams with end to end process analysis
- 2+ years with medical claim processing
- Intermediate knowledge of Word, Excel, and Powerpoint
Assets:
- Any Six Sigma or Lean Training preferred
Soft Skills:
- Exceptional verbal and written communication skills
- Analytical thinker who is able to identify root cause and come up with solid solutions
UnitedHealthcare, part of the UnitedHealth Group family of companies, is comprised of three specialized businesses dedicated to meeting the health care benefits needs of individuals and groups; all part of something greater, but each with a specialized focus:
UnitedHealthcare Employer & Individual works with individuals, small businesses and large multi-site employers to provide innovative, affordable benefits services.
UnitedHealthcare Medicare & Retirement is focused on serving Americans over the age of 50. It is the largest business dedicated to meeting the growing health and well-being needs of aging individuals in the nation, serving one in five Medicare beneficiaries through a comprehensive and diversified array of products and services through four industry-leading businesses.
UnitedHealthcare Community & State provides high-quality, personalized, public-sector health care programs that help local government agencies improve health outcomes for millions of children and low-income and disabled individuals at an affordable cost.
Together, we're removing the barriers that keep people from receiving the kind of quality health care that makes a difference. We focus on Integrity, Compassion, Relationships, Innovation and Performance as we empower people to achieve better health and well-being.
Come grow and thrive in our culture of innovation and ideas. Because there is no opportunity greater than the quest to help people live healthier lives. Join us and start doing your life's best work.
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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