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Senior Claims Quality/Audit Representative - Kingston, NY
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Kingston, NY Kingston, New York |
About this job
Position Description:
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.
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
- Intermediate Microsoft Word and Excel knowledge required, Microsoft Access knowledge preferred..
- 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
Requirements:
Physical Requirements and Work Environment:
- An education level of high school diploma/GED or at least 10 years of relevant working experience
- 1+ years of experience with MS
Excel – Ability to
navigate, update, analyze information within Excel workbooks - 1+ years of experience with MS Word – Ability to
create documents/tables and edit/update existing documents - 1+ years of experience with UNET – Ability to
navigate and understand the various screens within the UNET application to
review claims/eligibility/provider information, and adjust claims processed
incorrectly, etc...
1+ years of experience with NDB – Ability to
research provider information, fee schedule information, etc...
1+ years of experience with EDSS/IDRS – Ability
to access/view/research archived information.- 1+ years of experience with Knowledge Library – Ability to
navigate Knowledge Library and interpret guidelines/policies and their
applicability to the Empire Plan.
Physical Requirements and Work Environment:
- Extended periods of sitting at a computer and use of hands/fingers across keyboard or mouse
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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