Senior Recovery Resolutions Representative - Houston, TX - Full-time / Part-time

Position Description:

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.



Our claims operations are the focal point of handling information about
services patients receive and the way those services get paid. It's complex,
detailed work. It's also fast paced and challenging. 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.



Are you looking to be on the forefront of reducing the cost of healthcare
through cost containment and compliance? Do you consider yourself a critical
thinker, problem solver, and process improver? Do you have the ability to
analyze numbers and identify trends while being able to build lasting
relationships? Do you want to work for one of the leading revolutionary
healthcare companies that affect every aspect of the healthcare system?



The Senior Recovery Resolution Representative (Regional Account Manager) role
handles information about patient services and how those services are paid by
investigating and pursuing recoveries through contact with various parties.
This role has 2 primary functions. First, you will be reviewing and analyzing
contract rates on accounts at the hospital business office. You will be
required to use basic math in all of your daily activities. As field-based
employees who work onsite at our client?s offices; relationship building is
another crucial function of the position. Acclimating to our client?s
environment and learning about their primary goals and objectives is essential,
and ensures a successful partnership. Regional Account Managers are responsible
for regular communication with client contacts at all levels to follow-up on
open AR, discuss reporting and any assigned projects etc. We offer the latest
tools along with the most intensive training program in the industry and nearly
limitless opportunities for advancement. This position also offers quarterly
incentives based on performance.



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
• Plan, prioritize, organize and complete work to meet
  established production goals or quotas in a fast pace and ever changing
  environment
• Provide expertise in credit balance adjudication by
  reviewing, researching, and resolving all types of accounts as well as
  providing resolution outcomes for health plans, commercial customers and
  government entities
• Establish professional working relationships to ensure
  operational efficiency
• Anticipates customer needs and proactively identifies
  solutions
• Accounts receivable follow up and resolution
• Analyze and identify trends and provide reporting as
  necessary
• Ensure adherence to state and federal compliance
  policies, reimbursement policies and contract compliance
• 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:

• High school diploma or GED
• 2+ years of claims or collections experience
• 1+ years of customer service experience analyzing and
  solving customer problems
• 1+ years of experience working within the healthcare
  industry in an office setting 
• Intermediate level of proficiency with Excel required
  (i.e. sorting, summing, creating bar graphs, formulas)
• Ability to travel, 3 week training program held in
  Tennessee and then up to 25% of the time (generally local, but some
  overnight) required.

• Previous experience working in a client facing role
  and/or working onsite at a client site
• 3+ years of experience in claims recovery and
  resolution
• 2+ years of Account Management experience
• Previous leadership experience
• Previous work within the community giving back or
  volunteering time and resources

Physical Requirements and Work
Environment:

• 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.