Senior Recovery Resolution Analyst

Overview

This position is National Remote. You'll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives?

Join us to start Caring. Connecting. Growing together.

Senior Recovery/Resolution Analyst will work with a team on researching issues to determine feasibility of reducing medical costs through prospective solutions of claim system processes and claim business rules.

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.

We offer weeks of on-the-job training. The hours of the training will be aligned with your schedule.

• Perform clinical review of professional claims vs. medical records to determine if the claim is supported or unsupported.
• Maintain standards for productivity and accuracy.
• Provide clear and concise clinical logic to the providers when necessary.
• Attend and provide feedback during monthly meetings with assigned internal customer department.
• Provide continuous feedback on how to improve the department relationships with internal team members and departments.
• Keep up required Coding Certificate
• Complete compliance hours as required by the department.

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.

• High School Diploma / GED
• Certified Coding Specialist (CCS), OR Certified Professional Coder (CPC)
• Must be 18 years of age OR older
• Working knowledge of medical terminology and claim coding.
• Knowledge of claims processing systems and guidelines/processes
• Experience with Microsoft Excel (create, edit, sort, filter)
• Ability to work full-time (40hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm. It may be necessary, given the business need, to work occasional overtime.

• 1+ years of Medical record coding experience with experience in Evaluation and Management Services in the professional setting.
• Knowledge of Medicaid/Medicare Reimbursement methodologies

• Ability to keep all company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
• Must live in a location that can receive a United Health Group approved high-speed internet connection or leverage an existing high-speed internet service.

* All employees working remotely will be required to adhere to United Health Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The hourly pay range for this role is $28.94 - $51.63 per hour based on full-time employment.

We comply with all minimum wage laws as applicable.

Final date to receive applications: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At United Health Group, our mission is to help people live healthier lives and make the health system work better…