Senior Recovery Resolutions Analyst - Franklin, TN

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 Primary Responsibilities:
 

Examine, assess, and document business operations and procedures to ensure data integrity, data security and process optimization.
Investigate, recover, and resolve all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities
Investigate and pursue recoveries and payables on subrogation claims and file management
Initiate phone calls to members, providers, and other insurance companies to gather coordination of benefits information
Process recovery on claims
Ensure adherence to state and federal compliance policies, reimbursement policies, and contract compliance
Use pertinent data and facts to identify and solve a range of problems within area of expertise
May conduct contestable investigations to review medical history.
May monitor large claims including transplant cases.
Generally work is self-directed and not prescribed.
Works with less structured, more complex issues.
Serves as a resource to others.

Requirements:
 

High school diploma or GED.
Experience working with medical claims platforms
2+ years of experience with claims auditing and researching claims information
1+ year of experience analyzing data and identify cost saving opportunities
Knowledge of claims processing systems and guidelines/processes
Experience performing advanced analysis, formulas, data capture, charts, graphs, and presentations  with MS Excel
Experience in healthcare
Assets:
 

Knowledge of Medicaid/Medicare Reimbursement methodologies
Experience creating and working within a Database with MS Access
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.