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Claims Adjustment Representative - Richardson, TX
| Hours | Full-time, Part-time |
|---|---|
| Location | Richardson, TX Richardson, Texas |
About this job
We're growing in Richardson, TX!
Learn more about our Customer Service and Claims openings in at:
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 health care 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.
The Adjustment Representative is responsible for efficiently navigating claim processing systems to complete all closed and denied, simple adjustments, and the majority of complex adjustments (out of scope are high dollar and inpatient). Also, the adjustment representative will provide quality service to our Providers through real time and accurate resolution of closed and denied claims, simple adjustments and escalated claim issues.
Responsibilities:
- Perform all types of complex adjustments and closed, denied, and simple adjustments
- Meet Quality, Productivity and Attendance requirements
- Ensure Provider Satisfaction through:
- Maintaining accurate documentation in ORS
- Providing assistance to Providers with status updates
- Being responsible for any follow-up work needed for resolving and closing issues
- Identifying and resolving anticipated Provider issues to prevent future calls
- Maintaining accurate documentation in ORS
- Maintain proficiency in all technical applications (technical skills and system knowledge)
- Comply with all current policies, procedures and workflows
Requirements
- 1-2 years of medical, health care, or office experience
- English/Spanish Bilingual Preferred
- Available to work 40 hours per week within the operating hours of the site of 6:00am to 6:00pm, Monday-Friday.
- An education level of at least a high school diploma or GED OR 10 years of equivalent working experience
- Authorization to work in the United States
- Technical experience with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
- Ability to remain focused and productive each day though tasks may be repetitive
- Effective communication skills
- Extended periods of sitting at a computer and use of hands/fingers across keyboard or mouse
- Office environment
There 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 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.SM
Diversity creates a healthier atmosphere: 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: customer service representative, customer service, CSR, UnitedHealth Group, call center, UnitedHealthcare, health care, office, phone support, training class, claims, adjustment