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in Hartford, CT
Senior External Audit Consultant - US Telecommute or any UHG Office - Full-time / Part-time
•30 days ago
Hours | Full-time, Part-time |
---|---|
Location | Hartford, CT Hartford, Connecticut |
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.SM Our claims
operations, are the focal point of handling information about services
patients receive and the 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.
As a key
member of the team, supports Benefit Operations readiness reviews for
external audits. Individual serves a single point of contact for
external partners and internal business partners and brings forward to
Benefit Operations the audit scope as it relates to operational process
reviews and defines operational involvement. This position is a
functional SME, has a broad business approach, develops pioneering
approaches to emerging industry trends and is a resource to senior
leadership. Has oversight of related activities across functional areas
and communicates project progress through stage gate reviews and
documented adherence action plans in accordance to operational readiness
review model.
Primary Responsibilities:Implement claim payment processes that meet regulatory requirements and claim business rules. Conduct claims systems utilization, capacity
analysis/planning and reporting, and claims-related business and systems
analysis. Ensure data integrity, data security and process optimization.Serve as our internal Regulatory Affairs' point of contactPartner with functional area leaders and SMEs to determine impact and solutionsImplement Claim ops solutions to meet regulatory requirementsLead Claim Ops market conduct or financial exam activity, corrective action plans responses and restitution projects Remediate gaps in existing production processes that do not meet regulatory requirements
Requirements
Requirements:
High School Diploma/ GED5+ years of working experience 3+ years of Medical/ Healthcare claims processing experience2+ years of Project Management experience 2+ years of Supervisory or Team Lead experience Knowledge of State and Federal regulations that govern state health insurance claim payment3+ years of experience with Microsoft Excel
Assets:
Bachelor degree or higherKnowledge of CSP Facets and/or COSMOS internal claims processing platformsTake the next step, online at: www.yourlifesbestwork.com
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.Keywords: UHG, UHC, healthcare, project management, medical
High School Diploma/ GED5+ years of working experience 3+ years of Medical/ Healthcare claims processing experience2+ years of Project Management experience 2+ years of Supervisory or Team Lead experience Knowledge of State and Federal regulations that govern state health insurance claim payment3+ years of experience with Microsoft Excel
Assets:
Bachelor degree or higherKnowledge of CSP Facets and/or COSMOS internal claims processing platformsTake the next step, online at: www.yourlifesbestwork.com
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.Keywords: UHG, UHC, healthcare, project management, medical