Senior Healthcare Call Center Representative - Houston, TX - Full-time / Part-time

Position Description: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.SM 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.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 entitiesAnalyze, identify trends, and provide reports as necessaryEnsure adherence to state and federal compliance policies, reimbursement policies, and contract complianceManage subrogation filesPerform other duties as assignedExtensive 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 GEDWorking hours:  8am-4:30pm M-F2+ years of experience within the healthcare, claims, or insurance industries2+ years of customer service/call center experienceIntermediate proficiency with MS Office- Excel (data entry, reporting, data analysis)Assets:Bachelor's DegreeKnowledge of medical terminologyPhysical 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 computerService center environment with moderate noise level due to Representatives talking, computers, printers, and floor activityCareers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.SMDiversity 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.