Claims Representative - Work From Home

Careers at UnitedHealth Group

We're creating opportunities in every corner of the health care marketplace to improve lives while we're building careers. At UnitedHealth Group, we support you with the latest tools, advanced training and the combined strength of high caliber co-workers who share your passion, your energy and your commitment to quality. Join us and start doing your life's best work. SM

Clinical

Compassion. It's the starting point for health care providers like you and it's what drives us every day as we put our exceptional skills together with a real feeling of caring for others. This is a place where your impact goes beyond providing care one patient at a time. Because here, every day, you're also providing leadership and contributing in ways that can affect millions for years to come. Ready for a new path? Learn more, and start doing your life's best work. SM

Our teams are helping people from around the world. We can bring out your best as you put your listening, analytical and problem solving skills to work in a setting that is geared to helping improve lives and enhance health care for millions. Here, you'll discover a wealth of pathways for professional growth within Customer Service, Billing, Claims, Enrollment & Eligibility and across our global economy. Join us and find out why this is the place to do your life's best work. SM

If you are located within commutable distance of Hooksett, NH, you will have the flexibility to telecommute* (work from home) as you take on some tough challenges.

It's that time, isn't it? You're ready for the next step forward and an opportunity to build on your skills. And it just so happens that there's never been a better time to get on the team at UnitedHealth Group. We've built one of the world's most effective and respected claims processing teams. And that's where you come in. We'll look to you to maintain our reputation for service, accuracy and providing a positive claims experience. We'll back you with the great training, support and opportunities you'd expect from a Fortune 10 company leader.

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 8:00am - 5:00pm. It may be necessary, given the business need, to work occasional overtime. Employees will be working from home two (2) days per week and onsite three (3) days per week. Our office is located at 114 Central Park Drive Hooksett, NH 03106.

*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, Knowledge Library)
  • 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 on a daily basis all documentation and communicate the status of claims as needed adhering to all reporting requirements
  • Communicate through correspondence with peers, leaders and business partners, 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 USP training program (requires ability to read complex information and demonstrate proficiency through testing and practical application)

This is a challenging role that takes an ability to thoroughly review, analyze and research complex healthcare claims in order to identify discrepancies, verify pricing, confirm prior authorizations and process them for payment. You'll need to be comfortable navigating across various computer systems to locate critical information. Attention to detail is critical to ensure accuracy which will support timely processing of the member's claim.

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 5+ years of equivalent working experience
  • Porficiency with computer and Windows PC applications, (Microsoft Office software applications including Word (creating, editing, saving and sharing documents), Excel (creating, saving, editing, sharing files, using formulas) and Outlook (creating rules and using calendar, creating, copying, editing, saving and sending correspondence)) which includes the ability to learn new and complex computer system applications

Telecommuting Requirements:
  • Reside within commutable distance of Hooksett, NH including the ability to work onsite 3 days per week
  • 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:
  • Experience working with multiple products and multiple levels of benefits within each product

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 https://uhg.hr/transitioning-military

Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible. https://uhg.hr/vet

Making claims a positive experience for our members can drive your sense of impact and purpose. Join us as we improve the lives of millions. Learn more about how you can start doing your life's best work. SM

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 5 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. SM

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.

Keywords: Healthcare, health care, Managed Care, Billing Representative, Billing, Collections, Claims, Customer Service, Medical Billing, work at home, work from home, WAH, WFH, remote, telecommute, hiring immediately, #RPO

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