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in Brentwood, TN

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Hours Full-time, Part-time
Location Brentwood, TN
Brentwood, Tennessee

About this job

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 17 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 & Performance. 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 standardsRespond to claims appealsSupervise, monitor, track and direct day to day operations to staffConsistently meet established productivity, schedule adherence, and quality standardsRespond to claims appealsResponsible for handling one or more of the following tasks within turnaround and quality standards as applicableManage escalationsManage inventory and performance to business metricsWork with internal/external business partnersSubmit P&P update requestsSubmit new macro requests or macro updatesReview team quality rebuttals and support team remediation plans/initiativesPerform monthly mentoring or coaching and development for team membersProvide team members with monthly scorecardsComplete required individual development courses/trainingsProvide expertise or general claims support to team in reviewing, researching, investigating, negotiating, processing and adjusting claims.Identify and resolve operational problems using defined processes, expertise and judgment.Conduct analysis and identify trends and provide reports as necessary.Support team employee engagement and continually working to meet and/or improve vital signs resultsWork/Lead special projects as assignedSupport and participate in social responsibility events throughout the yearBack-up for other supervisors or manager as neededHost/Attend meetings as requiredCoordinates, supervises and is accountable for the daily activities of business support, technical or production team or unitImpact of work is most often at the team levelCoordinates, 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.

Requirements

Required Qualifications: High School Diploma or GEDModerate proficiency with Windows PC applications - Word (Ability to create/edit document); PowerPoint (Ability to create and send presentations); Excel (Vlookup and formulas) Assets: 5+ years of experience analyzing and solving customer problems in an office setting environmentSoft Skills: Team playerSupport core values within the team/organizationSupport team engagement initiativesAttention to detailOrganizational skillsProblem solving skillsEffective communication skills (verbal and written)Ability to work independently and make sound decisions in a fast paced environmentAbility to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each productPhysical Requirements and Work Environment: Extended periods of sitting at a computer and use of hands/fingers across keyboard or mouseOffice environmentCareers 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. Keywords: medical claims, healthcare claims, claims processing, claims processor; UnitedHealth Group, UnitedHealth care Â