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in Las Vegas, NV

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Hours Full-time, Part-time
Location Las vegas, Nevada

About this job

If you are located within MST and PST, Arizona Time Zone, you will have the flexibility to telecommute* (work from home) as you take on some tough challenges.



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 5 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.



Employees in this position will work on-site or virtually as an extension of the local quality and provider teams by aligning to geographical regions, medical centers and/or physician practices that manage a high volume of UHC Medicare & Retirement membership. This position does not entail any direct member care nor does any case management occur.



Position Summary:



This position is responsible for conducting a quality review of all Equian external documents, internal process review and reporting quality assurance results.  This position also conducts research as required to support audit exceptions and resolve issues. 



This position is full-time (40 hours/week) Monday- Friday. Employees are required to have flexibility to work any of our 8 hour shift schedules during our normal business hours of (7:30am-5:00pm PST or MST, Arizona Time Zone). It may be necessary, given the business need, to work occasional overtime.



*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.



General Duties and Responsibilities




  • Conduct quality reviews of all eligible Equian external documents, to include Forensic Reports, Appeal Responses and calculations, Reports delivery to clients and providers

  • Complete miscellaneous production-related tasks as required for support including: scan records, process triage forms and process referrals.

  • Perform research to support quality review findings, exceptions and resolve issues

  • Perform research to create new exceptions and business rules, process improvement suggestion and review

  • Understand and maintain HIPAA confidentiality and privacy standards when completing assigned work

  • Participate in department and company meetings as requested

  • Complete special projects as assigned



You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.


Required Qualifications:




  • High school diploma / GED (or higher) OR equivalent experience

  • 1+ years of experience in medical billing/coding and medical claims review

  • 1+ years of experience in quality review/assurance in medical claims



Preferred Qualifications:




  • Familiarity with medical terminology and coding

  • Advanced computer skills, specifically Microsoft Excel



Telecommuting Requirements:




  • Reside within MST and PST, Arizona Time Zone

  • Required to have a dedicated work area established that is separated from other living areas and provides information privacy

  • Ability to keep all company sensitive documents secure (if applicable)

  • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service



Soft Skills:




  • Strong organizational skills and attention to detail

  • Excellent analytical skills

  • Ability to multi-task and work with little direction.  A self-starter.

  • Good verbal and written communication skills

  • Team player demonstrating enthusiasm and commitment to company vision and mission

  • Ability to be a positive representative of the Company both internally and externally.

  • Ability to work with respect and cooperation at all times with fellow employees and clients.



UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.



Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at



Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible. 



Careers with OptumInsight. Information and technology have amazing power to transform the Healthcare industry and improve people's lives. This is where it's happening. This is where you'll help solve the problems that have never been solved. We're freeing information so it can be used safely and securely wherever it's needed. We're creating the very best ideas that can most easily be put into action to help our clients improve the quality of care and lower costs for millions. This is where the best and the brightest work together to make positive change a reality. This is the place to do your life’s best work.SM



Colorado or Nevada Residents Only: The salary range for Colorado residents is $16.00 - $26.88. The salary range for Nevada residents is $16.83 - $29.66. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives



Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and 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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