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Claims Quality Analyst - US Telecommute
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | San Antonio, TX San Antonio, Texas |
About this job
Position Description:
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. Claims Quality Analysts are responsible for all aspects of quality assurance within the Claims job family. Conduct audits and provide feedback to reduce errors and improve processes and performance.
Primary Responsibilities:
- Provide claims support by reviewing, researching, investigating, auditing claims
- Provide feedback to team members on audit results
- Analyze and identify trends and provide feedback and reports to reduce errors and improve claims processes and performance
- Responsible for all aspects of quality assurance
- Analyze information and utilize to build recommendations to reduce errors and improve process performance
- Create, maintain and track reports in relation to performance
- Serve as subject matter resource to team members, supervisors and management staff
- To be most successful in this role, candidates should have Appeals & Grievance experience as well as experience with Medicare & Retirement Part D.
- Positions in this function are responsible for all aspects of quality assurance within the Claims job family. Conducts audits and provides feedback to reduce errors and improve processes and performance.
- Basic, structured, standard approach to work.
Requirements
Requirements:
- High School Diploma or GED required
- 1+ years of experience with Medicare
Products - 1+ years of experience analyzing and
solving customer problems in an office setting environment - Ability to read and interpret
standard operating processes and procedures - Moderate proficiency with computer and Windows PC applications, which includes
the ability to learn new and complex computer system applications - Ability to multi-task, this includes ability to understand multiple products
and multiple levels of benefits within each product - Basic understanding of Microsoft Access
Assets:
- Undergraduate Degree or higher
- Experience with Medicare and Retirement
- Experience with claims processing and adjustments
- Medical Coding Certification preferred
Soft Skill:
- Ability to communicate with all levels and areas of the business
Physical Requirements and Work Environment:
- Extended periods of sitting at a computer and use of hands/fingers across keyboard or mouse
- Office environment
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.