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Provider Issue Resolution Specialist - Richardson, TX
| Hours | Full-time, Part-time |
|---|---|
| Location | Richardson, TX Richardson, Texas |
About this job
Don't wait to apply - we have training classes starting soon that are designed to set you up for success!
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 health care
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.
The Provider Issue Resolution Specialist (PIRS)
is responsible for efficiently navigating claim processing systems to
complete all closed and denied, simple adjustments, and the majority of
complex adjustments (out of scope high dollar and inpatient). Also, the
PIRS will provide quality service to our Providers through real time
and accurate resolution of closed and denied claims, simple adjustments
and escalated claim issues.
Responsibilities:
- Perform all types of complex adjustments and closed, denied, and simple adjustments
- Meet Quality, Productivity and Attendance requirements
- Ensure Provider Satisfaction through:
- Maintaining accurate documentation in ORS
- Providing assistance to Providers with status updates
- Being responsible for any follow-up work needed for resolving and closing issues
- Identifying and resolving anticipated Provider issues to prevent future calls
- Maintain proficiency in all technical applications (technical skills and system knowledge)
- Comply with all current policies, procedures and workflows
Requirements
- 2 years of Claims, Office, or Customer Service experience analyzing and solving customer problems
- Knowledge of medical claims billing ICD9, CPT, or HCPC codes
- English/Spanish Bilingual Preferred
- An education level of at least a high school diploma or GED OR 10 years of equivalent working experience
- Authorization to work in the United States
- Familiarity with computer and Windows PC
applications, which includes the ability to learn new and complex
computer system applications - Ability to remain focused and productive each day though tasks may be repetitive
- Effective communication skills
- Available to work 40 hours per week within the operating hours of the site of 6:00am to 6:00pm, Monday-Friday.
Work Environment:
- Extended periods of sitting at a computer and use of hands/fingers across keyboard or mouse
- Office environment
There are several
steps in our hiring process - it's a thorough process because we want to
ensure the best job and culture fit for you and for us. In today's
ultra-competitive job market, the importance of putting your best foot
forward is more important than ever. And you can start by completing all
required sections of your application. (i.e. profile, history,
certifications and application/job questions). Once you submit your
resume, you'll receive an email with next steps. This may include a link
for an on-line pre-screening test that we ask you to complete as part
of our selection process. You may also be asked to complete a digital
video interview, but we will offer full instructions and tips to help
you. After you have completed all of these steps, you can check on the
status of your application at any time, but you will also be notified
via e-mail.
Careers with UnitedHealthcare.
Let's talk about opportunity. Start with a Fortune 14 organization
that's serving more than 85 million people already and building the
industry's singular reputation for bold ideas and impeccable execution.
Now, add your energy, your passion for excellence, your near-obsession
with driving change for the better. Get the picture? UnitedHealthcare is
serving employers and individuals, states and communities, military
families and veterans where ever they're found across the globe. We
bring them the resources of an industry leader and a commitment to
improve their lives that's second to none. This is no small opportunity.
It's where you can do your life's best work.SM
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.
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