Claims Adjustment Specialist - Phoenix, AZ - Full-time / Part-time

Grow your career with an industry leader! We have training classes starting soon. Apply now!You’re looking for something bigger for your career. You’re looking for a place where you will be empowered to be your best. When you join UnitedHealthcare, you’ll be part of a team committed to reshaping the way health care works for millions. You’ll join us on a mission to not only deliver the best customer service in the health care industry, but the best customer service. Period. You won’t just provide customer service; you’ll change health care for the better starting with every health care provider you talk to. Your commitment to supporting them will directly translate into better care for their patients. And you’ll be well supported with the latest tools and advanced training classes to set you up for success. Don’t wait to join us! There’s never been a better time than now to start doing your life’s best work. (SM)When you join our team as a Claims Adjustment Specialist, you’ll be responsible for reviewing and making adjustments or corrections to processed claims through researching, investigating issues, making a determination and then communicating as required. You will authorize the appropriate adjustment insuring compliance with all requirements.  Conducting data entry and re-work; analyzing and identifying trends as well as providing reports as necessary will also be a part of your daily routine.  As a Specialist, you will also serve as a point of contact for questions/escalations from internal and external customers.This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8 hour shift schedules during our normal business hours of (6am - 6pm). Our office is located at 4425 E Cotton Center BLVD, Phoenix, AZ 85040.Primary Responsibilities:Review and research  project or more complicated  claims by navigating multiple computer systems and platforms and accurately capturing the data/information necessary for processing (e.g. verify pricing, prior authorizations, applicable benefits, coding)Update claim information based on research and communication from member or providerComplete necessary adjustments to claims and ensures the proper benefits are applied to each claim by using the appropriate processes and procedures (e.g. claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/certificates)Complete on a daily basis all data entry required to document and communicate the status of claims as needed adhering to all reporting requirementsCommunicates extensively  with members and providers regarding adjustments to resolve claims errors/issues, using clear, simple language to ensure understandingLearn and leverages new systems and training resources to help apply claims processes/procedures appropriately (e.g. on-line training classes, coaches/mentors)Meet the performance goals established for the position in the areas of: efficiency, accuracy, quality, member satisfaction and attendance

2-3 years of Claims, Office, or Customer Service experience analyzing and solving customer problemsAn education level of at least a high school diploma or GED OR 10 years of equivalent working experienceFamiliarity with computer and Windows PC applications, which includes the ability to learn new and complex computer system applicationsAdvanced written communication skills including grammatical composition and spelling (ability to write error free letters to translate medical and insurance jargon and complex processes into simple, step-by-step letters that members can understand)Ability to multi-task including  the ability to understand multiple products and multiple levels of benefits within each product, as well as to navigate between various computer applications/systems to conduct research and to respond to membersConsistent attendance with ability to meet work schedule including the required training periodSuccessful completion of the UnitedHealth Group new hire training and demonstrated proficiency requiredThere are several steps in our hiring process - it’s a thorough process because we want to ensure the best job and culture fit for you and for us. In today’s ultra-competitive job market, the importance of putting your best foot forward is more important than ever. And you can start by completing all required sections of your application. (i.e. profile, history, certifications and application/job questions). Once you submit your resume, you’ll receive an email with next steps. This may include a link for an on-line pre-screening test that we ask you to complete as part of our selection process.  You may also be asked to complete a digital video interview, but we will offer full instructions and tips to help you. After you have completed all of these steps, you can check on the status of your application at any time, but you will also be notified via e-mail..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: claims, medical claims, healthcare claims, claims processing, claims processor; office, UnitedHealth Group, UnitedHealthcare,  training class, customer service representative, customer service, CSR, Data Entry, adjustments, phone support