Senior Recovery \/ Resolution Representative - Fort Worth, TX

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

This role is temporarily remote. Training is conducted virtually from your home. This role is an onsite role and once training is completed, you will transition to work in the office in the future.

Combine two of the fastest - growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making Healthcare data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work. SM

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

Primary Responsibilities:
  • Provide expertise by reviewing, researching, resolving all accounts from credit balance to bring final resolution and root cause analysis for health plans, commercial clients, and government entities
  • Fundamental Execution:
  • Plan, prioritize, organize and complete work to meet established production goals required by provider and payer clients, Optum goals, quotas and deadlines in a fast-paced ever-changing environment.
  • Provide top quality by researching accounts fully, reviewing and adhering to payer, provider and Optum quality requirements.
  • Client facing account management:
  • Represent Optum and Optum's core values; act as a liaison between provider clients, Optum and payer clients.
  • Communicate and/or meet with the provider client appropriately to ensure Optum is meeting their needs and expectations. Building a good rapport with the provider client contacts by establishing professional working relationships to ensure operational efficiency.
  • Anticipates client needs and proactively identifies solutions.
  • Be accountable for improving business operations.
  • As a RAM, you will be required to use basic math in all your daily activities. As field-based employees who work onsite at our clients' offices, relationship building, and growth are another crucial function of the position. Acclimating to our clients' environment and learning about their primary goals and objectives is essential and ensures a successful partnership.

Inventory Management:
  • Accounts receivable follow up, resolution and ensuring AR is resolved within 30 days. Follow up includes researching why inventory is outstanding with the provider and payer clients.
  • Manage multiple different inventory work queues and workflows including:
    • Multiple payer, provider client referred inventory and unsolicited inventory.
    • Reporting & Analysis:
  • Analyze and identify trends, provide reporting as necessary to the provider clients, management, and the Centers of Excellence (COE).
  • Utilize various reports to manage inventory, follow up as needed and drive client relationships
    • Work independently with little direct onsite supervision.
    • Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance.

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)
  • Experience working with medical claims platforms
  • 2+ years of experience with claims auditing and researching claims information
  • 1+ years of experience analyzing data and identify cost saving opportunities
  • Knowledge of claims processing systems and guidelines/processes
  • Intermediate skills with Excel (create, edit, save and send spreadsheets)
  • Experience in healthcare
  • Ability to travel 25% of the time

Telecommuting Requirements:
  • 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

Preferred Qualifications
  • Experience working with subrogation
  • Experience with negotiations

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

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to 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.

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