Overpayment Calculation Analyst - Eden Prairie, MN - 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 14 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, and Performance.
 
In this role, you will be responsible for  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 Process recovery on claims. Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance.
 
Primary Responsibilities:

Obtain all available data relevant to investigation/overpayment identifications
Conduct/utilize investigations/overpayment identifications to determine accuracy of claims payments Retrospectively.
Analyze contractual requirements to determine if funds are owed to payers
Perform research/verification of identified claims to identify payment/overpayment issues/accuracy
Enter information into applicable systems to track processing of claims investigations and/or to ensure that all information relevant to the claim is documented
Complete file set up on subrogation/workers' compensation cases
Work with payers/providers to review claim information and identify issues related to payment accuracy
Update applicable claims systems to ensure that claims payments reflect accurate payment levels.
Document and communicate outcomes of claims investigations/overpayment reviews to applicable stakeholders

Required Qualifications:

High School Diploma/GED
5+ years of experience in the Healthcare industry 
Previous experience with Microsoft Excel with the ability to create and use advanced formulas, pivot tables, and VLOOKUP
Knowledge of Physician's and Hospital Reimbursement Methodology 
Experience with Recovery or Collection Tactics and Process.
Preferred Qualifications:

Previous experience with Claims Payments 
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
Careers 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.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.