Recovery Resolutions Representative - Eden Prairie, MN

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.

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
  expertise claims 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 and identify trends and provides reports as necessary
• Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance
• Data
  Enter key detail from the medical records and claim platform, into an
  online communication, or into the case tracking database.
• Research and handle returned mail.
• Handle outgoing mail
• Meet required metrics and quality.
• Adherence to State and Federal compliance and contractual requirements.
• Administrative support
• Extensive work experience within own function.
• Work is frequently completed without established procedures.
• Works independently.
• May act as a resource for others.
• May coordinate others activities.