Claims Representative Associate - Remote in New York

Company: UnitedHealth Group
Location: Staatsburg
Posted on: May 25, 2023

Job Description:

If you are located within the state of NY, you will have the flexibility to telecommute* (work from home) as you take on some tough challenges. At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life's best work.SMYou dream of a great career with a great company - where you can make an impact and help people. --We can offer you just this. And with the incredible growth of our business, it's a dream that can come true when you join us as an Associate Claims Representative. Already one of the world's leading health care companies, UnitedHealth Group is tirelessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives.-- Whether you have prior experience or not, we'll provide extensive training and a highly supportive environment for all of our Claims team members. This is your opportunity to make a difference, grow your career and do your life's best work.SMAs an Associate Claims Representative, you'll be responsible for analyzing complex healthcare claims that require research to determine action steps and mathematical calculations necessary to produce an accurate payment.---- The claims position requires a high level of quality which is to be maintained while achieving a productivity goal.-- You'll put your skills and talents to work as you review, research, and process medical claims. It's complex, detailed work. It's a 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. 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 6:00am - 6:00pm. 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.Primary Responsibilities:

• Review, research, solve and process assigned work. This would include navigating multiple computer systems and platforms (e.g. verify pricing, prior authorizations, applicable benefits)
• Ensure that the proper benefits are applied to each claim by using the appropriate tools, processes and procedures (e.g. claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/ certificates tool)
• Independently complete daily all documentation and communicate the status of claims as needed adhering to all reporting requirements
• Communicate through correspondence with members and providers regarding claim payment or required information, using clear, simple language to ensure understanding
• Learn and leverage new systems and training resources to help apply claims processes/procedures appropriately (e.g. on-line training classes, coaches/mentors)
• Meet and maintain the performance goals established for the position in the areas of quality, production and attendance
• Consistent attendance with ability to meet work schedule including the required training period
• Successful completion of the UnitedHealth Group 12 to 14-week new hire training program which is 60% instructor lead and 40% self-paced learning (requires ability to read complex information and demonstrate proficiency through testing and practical application)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 10+ years of equivalent working experience
• Working knowledge with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications (including comfort using macros efficiently)
• Ability to work full-time, Monday - Friday between 6:00am - 6:00pm including the flexibility to work occasional overtime given the business needPreferred Qualifications:
• Experience working with multiple products and multiple levels of benefits within each productTelecommuting Requirements:
• Reside within the state of New York
• 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 serviceCareers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of healthcare. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.SMNew York Residents Only: The salary range for New York residents is $16.00 - $27.31. 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.At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.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.#RPO #YELLOW------------------

Keywords: UnitedHealth Group, Danbury , Claims Representative Associate - Remote in New York, Other , Staatsburg, Connecticut