Welcome to one of the toughest andmost fulfilling ways to help people, including yourself. We offer the latesttools, most intensive training program in the industry and nearly limitlessopportunities for advancement.
Join us and start doing your life's bestwork.(sm)
Primary Responsibilities :
Responsible for monitoring andtracking the employee’s daily productivity through various reports
Provides daily direction andcommunication to employees
Responsible for establishing workprocedures that support the departmental standards procedures, and strategicdirectives
Troubleshoots claims to ensureaccurate payment
Provides statistical and performancefeedback and coaching on a regular basis to each team member
createand maintain high quality work environment so team members are motivated toperform at their highest level
Use appropriate judgment in upwardcommunication regarding department or employee concerns
Work as a member / leader of specialor on-going projects that are important to area / process improvement
Responsible for making suggestionsas to how the claims process system can be improved
Informs claims staff of any changesto Provider and Healthplan contracts
Be available for employees thatexperience difficulty in troubleshooting claims
Takes provider calls on difficultissues regarding claims
You’ll berewarded and recognized for your performance in an environment that willchallenge you and give you clear direction on what it takes to succeed in yourrole as well as provide development for other roles you may be interested in.
An education level of at least ahigh school diploma
Requires 2+ solid years’ continuous experienceworking as a Healthcare / Medical Claims Examiner . (Billing of Claims does not pertainto this position.)
Strong proficiency with computer andWindows PC applications, which includes the ability to learn new and complexcomputer system applications
Experience working on claims in a ManagedCare setting
Prior Medicare, HMO and Auditingexp. preferred
Working knowledge of medicalterminology, ICD9, CPT4, UB92, 1500 Form and FFS contract interpretations
Revenue and HCPCS coding skills preferred
Team Lead experience highlypreferred
Ability to multi-task, this includesability to understand multiple products and multiple levels of benefits withineach product
Demonstrates excellent interpersonalskills as discerned through observation and team project successes.
Accurately interprets and appliesdepartmental policies and procedures using sound judgment as is related toclaims processing.
Communicates clearly, professionallyand respectfully to peers, superiors, subordinates and clients.
Meets production quota for bothinput levels and accuracy on a weekly basis as set forth by the departmentstandards
Efficiently organizes andprioritizes workflow
Provides constructive feedback onwork projects assigned
Consistently produces accurate andtimely work product as it relates to departmental goals
Demonstrates high reliabilitythrough consistent punctuality and attendance
Demonstrates overall professionalismin attitude, demeanor and personal appearance
Careerswith Optum . Here's the idea. We built anentire organization around one giant objective; make the health system workbetter for everyone.
So when it comes to how we use the world's largeaccumulation of health-related information, or guide health and lifestylechoices or manage pharmacy benefits for millions, our first goal is to leapbeyond the status quo and uncover new ways to serve.
Optum, part of theUnitedHealth Group family of businesses, brings together some of the greatestminds and most advanced ideas on where health care has to go in order to reachits fullest potential.
For you, that means working on high performance teamsagainst sophisticated challenges that matter. Optum, incredible ideas in oneincredible company and a singular opportunity to do your life's best work.(sm)
OptumCare is committed to creatingan environment where physicians focus on what they do best : care for theirpatients. To do so, OptumCare provides administrative and business supportservices to both owned and affiliated medical practices which are part ofOptumCare.
Each medical practice part and their physician employees havecomplete authority with regards to all medical decision-making and patientcare.
OptumCare’s support services do not interfere with or control thepractice of medicine by the medical practices or any of their physicians.
Diversity creates a healthier atmosphere : UnitedHealth Groupis an Equal Employment Opportunity / Affirmative Action employer and allqualified applicants will receive consideration for employment without regardto race, color, religion, sex, age, national origin, protected veteran status,disability status, sexual orientation, gender identity or expression, maritalstatus, genetic information, or any other characteristic protected by law.
OptumCare is a drug-free workplace. Candidates are requiredto pass a drug test before beginning employment.
JobKeywords : Claims examiner, Managed Care, Team Lead, Medicare, HMO,Auditing, Medical Terminology, ICD9, ICD10, CPT4, UB92, 1500 Form, HCPCS
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