Claims Quality Analyst - US Telecommute - 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.

 

Flexible, Friendly, Fast on your
feet, that's a great start. Accurate, Accountable, Self-Directed, These traits
can take you places. Our claims operations are the focal point of handling
information about services patients receive and that way those services get
paid. It's complex, detailed work. It's fast paced challenge. 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. Claims Quality Analysts are
responsible for all aspects of quality assurance within the Claims job family.
Conduct audits and provide feedback to reduce errors and improve processes and
performance.


Positions in this function are responsible for all aspects of quality assurance
within the Claims job family. Conducts audits and provides feedback to reduce
errors and improve processes and performance.

 

Primary Responsibilities:

Provide claims support by reviewing, researching,
investigating, auditing claimsProvide feedback to team members on audit results Analyze and identify trends and provide feedback and
reports to reduce errors and improve claims processes and performanceResponsible for all aspects of quality assurance Analyze information and utilize to build
recommendations to reduce errors and improve process performanceCreate, maintain and track reports in relation to
performance Serve as subject matter resource to team members,
supervisors and management staff Medicaid and/or Medicare appeals and grievance
experience is required to have, and claims and adjustment experience is
valuable to have

Required Qualifications:

High School Diploma or GED1+ year of experience analyzing and solving customer
problems in an office setting environmentMedicaid or Medicare appeals and/or grievance
experienceModerate proficiency with computers and Windows PC
applications (this includes the ability to learn new and complex computer
system applications)Basic proficiency with Microsoft Excel (ability to work
in a spreadsheet and save a spreadsheet)

Preferred Qualifications:

Undergraduate Degree (or higher)3+ years of working experience in claims processing or
quality

Soft Skills:

 

Ability to multi-task (this includes ability to
understand multiple products and multiple levels of benefits within each
product)



Physical Requirements and Work Environment:

Extended periods of sitting at a computer and use of
hands/fingers across keyboard or mouseOffice environment 

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 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: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and 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.