Senior Recovery Resolutions Representative - US Telecommute - 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
• 2+ years of claims or collections experience
• 1+ years of customer service experience analyzing and solving customer problems
• 1+ years of experience working in the healthcare industry
• Intermediate proficiency with Microsoft Word and Excel