Prior Authorization, Quality Auditor - Las Vegas, NV

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)

Primary Responsibilities:

• Provide expertise claims support by reviewing, researching, investigating, auditing claims 


• Analyze and identify trends and provides feedback and reports to reduce errors and improve claims processes and performance


• Responsible for all aspects of quality assurance


• Position requires in-depth knowledge of the Facets system


• Experience in quality auditing of claims or system configuration highly preferred


• Positions in this function are responsible for all aspects of quality assurance within the Claims job family; conducts audits and provides feedback to reduce errors and improve processes and performance


• Extensive work experience, possibly in multiple functions


• Work does not usually require established procedures


• Works independently


• Mentors others


• Acts as a resource for others


• Coordinates others' activities

Required Qualifications:

• An education level of at least a high school diploma/ GED OR 10 years of equivalent working experience 


• 3+ years of experience in Medical claims


• 2+ years of Facets experience


• Intermediate level of proficiency with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications within: Word, Outlook, Excel - must be able to create graphs, sort data, and understand trending of data


• Ability to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each product

Preferred Qualifications:

• Encoder Pro experience


• Experience auditing claims

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.(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.

Job Keywords: Prior Authorization trainer, quality auditor, utilization management, quality audit, quality analysis, Spanish Ridge, Las Vegas, Nevada, NV