Senior Recovery Resolution Analyst - Franklin, TN - Full-time / Part-time

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.

• Examine, assess, and document business operations and procedures to ensure data integrity, data security and process optimization.


• Investigate, recover, and resolve all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities


• Investigate and pursue recoveries and payables on subrogation claims and file management


• Initiate phone calls to members, providers, and other insurance companies to gather coordination of benefits information


• Process recovery on claims


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


• Use pertinent data and facts to identify and solve a range of problems within area of expertise

Requirements:

• High School Diploma or GED


• 2+ years of phone based customer service


• 2+ years claims/ payer knowledge with government and commercial platforms (claims experience derived from working for a hospital, insurance company or healthcare consulting firm).


• 2+ years of previous contracting experience in a role such as Provider Contracting, Provider Service, or Claims QA


• Intermediate level of proficiency with Excel and Word (This person should be able to complete sorting, summing, and creating bar graphs and formulas within Excel and be able to create documents and open and read documents)
  

• 3+ years claims auditing/ research experience


• Experience with prior authorization or medical reviews


• Healthcare finance experience with a focus in auditing and/ or analysis (Ability to analyze numbers and Identify trends)
  

• 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
  

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, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.