Senior Healthcare Call Center Representative - Eden Prairie, MN - Full-time / Part-time

Position Description:

Energize
your career with one of Healthcare's fastest growing companies.  

 

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 Healthcare 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.

 

This
opportunity is with one of our most exciting business areas: Optum –a growing
part of our family of companies that make UnitedHealth Group a Fortune 17 leader.

 

Optum helps nearly 60
million Americans live their lives to the fullest by educating them about their
symptoms, conditions and treatments; helping them to navigate the system,
finance their healthcare needs and stay on track with their health goals. No
other business touches so many lives in such a positive way. And we do it all
with every action focused on our shared values of Integrity, Compassion,
Relationships, Innovation & Performance.

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

The Senior Recovery/Resolution Representative handles information about patient services and how those services are paid by investigating and pursuing recoveries through contact with various parties. The representative manages subrogation files, negotiates settlements, and ensures adherence to compliance policies.

Positions in this function are responsible for
investigating, recovering and resolving all types of claims as well as
recovery and resolution for health plans, commercial customers and
government entities. May include initiating telephone calls to members,
providers and other insurance companies to gather coordination of
benefits data. Investigate and pursue recoveries and payables on
subrogation claims and file management. Process recovery on claims.
Ensure adherence to state and federal compliance policies, reimbursement
policies and contract compliance. May conduct contestable
investigations to review medical history. May monitor large claims
including transplant cases.

Primary Responsibilities:

• Provide claims expertise support by reviewing, researching, investigating, negotiating, and resolving all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities
• Analyze, identify trends, and provide reports as necessary
• Ensure adherence to state and federal compliance policies, reimbursement policies, and contract compliance
• Manage subrogation files
• Perform other duties as assigned
• 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.

Requirements:

• High School Diploma or GED
• Working Hours M-F 8a-4:30p
  
• 2+ years of experience within the healthcare, claims,
  or insurance industries
• 2+ years of customer service/call center experience
• Beginner proficiency with MS Office- Excel (data entry,
  reporting, data analysis)  

Assets:

• Bachelor's Degree
• Knowledge of medical terminology  

Soft Skills:

• Strong oral communication skills, listening abilities,
  and problem solving capabilities
• Ability to maintain a pleasant, courteous and helpful
  demeanor at all times
• Ability to process and route calls in a timely manner
• Ability to multi-task, this includes ability to understand
  multiple products and multiple levels of benefits within each
  product
  

Physical Requirements and Work Environment:

• Frequent speaking, listening using a headset, sitting, use of hands/fingers across keyboard or mouse, handling other objects, long periods working at a computer
• Service center environment with moderate noise level due to Representatives talking, computers, printers, and floor activity

At
Optum, you will perform within an
innovative culture that's focused on transformational change in the Healthcare
system. You will leverage your skills across a diverse and multifaceted
business. And you will make contributions that will have an impact that's
greater than you've ever imagined.

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.