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Claims Clerk - International Falls,MN - Full-time / Part-time
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | International Falls, MN International Falls, Minnesota |
About this job
Position Description:
The Claims Clerk is responsible for providing expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting claims.
Primary Responsibilities:
- Provide general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims.
- Authorize the appropriate payment or refers claims to investigators for further review.
- Conduct data entry and re-work; analyzes and identifies trends and provides reports as necessary.
- Analyze and identify trends and provide reports as necessary
- Consistently meet established productivity, schedule adherence, and quality standards
- Recognize claims by determining claim type - HCFA, Hospital, UB, and/or RX
- Identify more complicated claims and refer them to Senior Claim Processor or Supervisor
- Calculate other insurance and re-pricing benefits
- Work claims files to ensure the appropriate eligibility and provider records are matched to the claim
- Updates and maintains claims tracking database
- 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.
- Limited work experience.
- Works on simple tasks using established procedures.
- Depends on others for guidance.
- Work is typically reviewed by others.
Requirements
Requirements:
- High School Diploma/ GED
- Available to work 40 hours per week within the operating hours of the site. Working Hours Monday - Friday 6:00AM - 2:30 PM or 7:00AM - 3:30 PM
- Moderate proficiency with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
- Ability to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each product
Assets:
- 1+ years experience working with medical claims
- Prior experience working with IDX software
- 1+ years working in production based environment
- Type 60+ words per minute
Soft Skills:
- Ability to remain focused and productive each day though tasks may be repetitive
- Extended periods of sitting at a computer and use of hands/fingers across keyboard or mouse
- Office environment
Careers 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.
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.
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