Research Analyst - Cypress, CA

Position Description:   

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.

Flexible, Friendly; fast on your feet, that's a great start. Accurate, Accountable, Self-Directed, These traits can take you places. Our claims operations are the focal point of handling information about services patients receive and the  way those services get paid. It's complex, detailed work. It's fast paced challenge. It's a job that calls on you to be thoughtful, resourceful, team-driven and customer-focused. To put it mildly, there is never a dull moment. Claims Quality Analysts are responsible for all aspects of quality assurance within the Claims job family. Conduct audits and provide feedback to reduce errors and improve processes and performance.

Primary Responsibilities: 

• Assists with the implementation of projects under the direction of senior management
• Ability to implement project documentation and files, review, track and manage requests for A&G tool enhancements and project work
• Coordinates meetings and follow up project work for receipt reconciliation activities
• Coordinates and documents automation and enhancement requests across functional teams and departments, communicating with A&G programming teams
• Communicates clearly and effectively with project team, including programmers, project leaders, business development and other researchers
• Conducts shadowing of multiple processes alongside automation teams to document business and compliance needs
• Learn new A&G tools functionality becoming familiar with all automation and reconciliation work
• Performs detailed review, research, and investigation on business feedback related to A&G Tool and reconciliation across all M&R Appeals and Grievances teams.  Responds to, and takes next steps as necessary for remediation.  Provides comprehensive evidence and documentation of all requests
• Supports ongoing A&G tool access changes.
  
• Understand all M&R Appeals and Grievances process and system documentation, in addition to knowledge of system automation and reconciliation processes.

Requirements:    

• High school diploma or GED, with strong bias for 4 year college degree
• Working Hours M-F 8a-5p, overtime is sometimes needed, so occasional Saturday work wll be required.
  
• Appeals, Grievances and/or claim processing experience at a senior level.
• Strong knowledge of PC programs (e.g. Word, Excel, and PowerPoint) with proven ability to navigate internal systems and SharePoint sites

Assets:

• Undergraduate Degree or higher
• Understanding of HIPPA requirements and UHG documentation handling policies and procedures

Soft Skills:

• Mastery level with all written
  communication skills: capable of drafting written correspondence with
  zero defects, with the ability to proactively identify errors that
  impact quality.
• Proven communication skills with the
  ability to quickly establish rapport and creditability in order
  influence outcomes at all levels across the organization
  
• Ability to communicate process
  failures and propose remediation, as well as developing remediation
  plans in all variety of mediums (verbal, writing, PowerPoint) to a
  broad audience level across the Appeals and Grievances organization.  
  

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 14 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can 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.