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Hours Full-time, Part-time
Location Moline, IL
Moline, Illinois

About this job

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.Positions in this function are responsible for providing expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting claims. Authorizes the appropriate payment or refers claims to investigators for further review. Conducts data entry and re-work; analyzes and identifies trends and provides reports as necessary.Primary Responsibilities:Provide expertise and/or general claims support to teams in reviewing, researching, negotiating, processing and adjusting claimsAuthorize appropriate payment or refer claims to investigators for further reviewAnalyze and identify trends and provides reports as necessaryConsistently meet established productivity, schedule adherence, and quality standards Supervise, monitor, track and direct day to day operations to staff Coordinates, supervises and is accountable for the daily activities of business support, technical or production team or unit Impact of work is most often at the team level Ensure proper controls are in place to eliminate risks to the operations Monitor performance and address opportunities as they arise Identify improvements and operational savings for the organization Coordinate claim issues through resolution with adjustments, appeal, and business partners Support on going initiatives with the Heath Plans or internal projects and provide claims guidance Lead staff or improvements to ensure the delivery meets customer expectations Manage a team or provide guidance in absence of the leader to ensure assignments are completed and performance expectations are achieved Able to run macros as need and identify additional automation needs to increase the auto vs manual percentage of claim processing

Requirements

Required Qualifications: High School Diploma or GED 2+ years of experience analyzing and solving customer or claim problems in an office setting environment 2+ years of experience with Medicare and Medicaid claims1+ years of experience managing or leading a team of 10-30 people to achieve high performance in process driven environmentKnowledge of CSP Facets Claims software usage Proficiency with computer and Windows PC applications (this includes the ability to learn new and complex computer system applications) Ability to create, edit, save, & send documents utilizing Microsoft Word and Excel Ability to use Microsoft PowerPoint to Develop Presentation of Data/Information to present to a group which might include management Preferred Qualifications: Undergraduate Degree or higher 1+ years of experience managing or leading a team of 10-30 people in Business operations of Healthcare, manage care, or insurance industry Understanding of UHC Claims processes and claim systems to process a claim to payment utilizing SOPs, 411s, and claims policies and proceduresSoft 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 mouse Office environmentCareers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 14 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.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.