**Description:** Review claims to ensure proper information is on the claim to complete processing based on the SOPs Request documentation to finalize the claim Identify contract-specific situations and manually calculate contract benefits using pricing and out-of-pocket procedures. Process claims in adherence with policies, procedures, and other applicable rules as well as claims quality and production standards **Skills:** Claim, Claims processing, Insurance, Health insurance, Health care, Medical, Hipaa **Top Skills Details:** 2 years of Healthcare Experience preferred Education Level: High School Degree or equivalent with two years or more post-secondary preferred 1-2 years Claims Processing Experience preferred (Not claims examining or auditing) Test scores for basic Excel **Additional Skills & Qualifications:** Prior healthcare-related experience in a payer or medical office/facility environment Microsoft suite (Word, Outlook, Basic Excel) Demonstrated flexibility to adapt...

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)The Financial Consultant in the revenue team will be responsible for the revenue analysis and accounting activities in the West Region including responsibilities for membership and revenue reconciliations, mid-month and month end revenue and membership calculations, support for monthly financial closings, financial analyses and reporting.You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities: Perform and review the monthly financial reconciliations related to various revenue sources for the health plans in the West region Lead the process to resolve the exceptions...

UnitedHealth Group is a company on the rise. We're expanding in multiple directions, across borders and most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the healthcare industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) The Contract Talent Acquisition Service Advisor (TASA) position is responsible for providing consultation and partnership to the Talent Acquisition organization including recruiters, hiring managers, vendor partners and various internal stakeholders. This position partners closely with recruiters, allowing them to focus their efforts on sourcing and identifying the best talent, while the TASA manages all the behind-the-scenes efforts and provides an enhanced candidate experience. As part of the Talent Acquisition Services team, the Contract TASA is responsible for processing a variety of tasks within the end to end recruitment process. Those...

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 health care 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) You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: To support and coordinate monthly development stage and production execution Support new Care Delivery Organization acquisition Coordinate data issues with HCE partners Participate in OptumCare Data Governance Support HCE data infrastructure development Coordinate with broader HCE team on data needs Providing framework for enriched datamarts delivered to CDOs You'll be rewarded...

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) The Broker & Employer Digital Product Strategist will partner with functional leads throughout the organization to understand and drive strategic vision and implementation of a new Broker and Employer portal experience. The Broker & Employer Digital Product Strategist will work to define, document, and own USP Migration Strategic Roadmap; own the digital billing experience; work with executive stakeholders to understand strategic E&I direction and priority and act as liaison to E&I, Digital and USP Leaders. You'll enjoy the flexibility to telecommute* from anywhere within United States as you take on some tough challenges....

Our finance professionals at UnitedHealth Group are engaged in the important work of making health care more affordable, simpler and easier for people to access. Now, more than ever we need finance and accounting professionals like you with the financial skills and discipline to help us achieve this goal. As a Financial Consultant you'll impact millions of lives. You will collaborate with an elite team of accounting and finance professionals who are writing the history of our organization and guiding our success as a global industry leader. Your performance and innovation will find a reception here like nowhere else. You'll find that this is place where you can do your life's best work.(sm)You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Support full P forecast end-to-end process Prepare analysis of monthly financial results against forecast & budget Clearly communicate forecast financials...

Tough challenges? We know a thing or two about those. When you're on a mission to help people live healthier lives, the stakes couldn't be higher. As a Business Analyst Consultant, you will help rewrite the future of the health care system. You'll analyze data and deliver bold, business-savvy ideas to impact the lives of millions. Along with ground-breaking challenge, you'll have the support and resources of a Fortune 5 company. Join us.Positions in this function conduct and manage outcomes of various studies that include analyzing, reviewing, forecasting, trending, and presenting information for operational and business planning. They support short and long term operational/strategic business activities - by developing, enhancing and maintaining operational information and models. They also develop and implement effective/strategic business solutions through research and analysis of data and business processes.You'll enjoy the flexibility to telecommute* from within the U.S. as you...

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) As a Contract Recruiter, you will be responsible for the recruitment of candidates across a broad spectrum of roles within United HealthCare. Our Recruiters are Talent Advisors who lead the end-to-end recruitment process and are accountable for talent sourcing and selection, consulting with Hiring Managers throughout the hiring process, providing detailed assessments for candidates, developing and managing talent pipelines and managing the offer and hiring process. This role reports directly to a Talent Acquisition Manager. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary...

No industry is moving faster than healthcare. And no organization is better positioned to lead healthcare forward. We need attention to every detail with an eye for the points no one has considered. You'll help improve the health of millions. And you'll do your life's best work.(sm) The Vice President of Organic Market Growth is responsible for achieving sustainable growth by developing comprehensive strategies to build strategic relationships and engage members and potential members. This leader will be accountable for managing the Medicaid Growth Team and developing annual, local growth plans aligned to marketing and segment growth and executing community-based growth plans that intentionally positions UnitedHealthcare Community & State for success. The leader is accountable for ensuring retention efforts effectively maintain membership and seeks innovative best practices throughout the organization and industry to ensure that retention efforts are best in class. To ensure...

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 health care 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) You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Identifying client requirements for Enterprise Data Catalog and onboarding client organizations Solutioning with client organizations and running POCs Owning end-to-end relationship with customers from onboarding to project delivery Working to automate onboarding process for the Enterprise Data Catalog to be self-service Designing and documenting processes to measure and report on...

In this role, you will be responsible for evaluating, development, implementation and execution of Immigration programs for short and long term transfers and assignments, new-hire domestic and international relocation and country entry support. Assists expatriates with international assignments through coordinating, developing, and/or managing some or all of the following: tax equalization, visa/immigration coordination, benefits coordination, housing and compensation packages. May also coordinate with relocation firms, immigration and tax vendors, and government and international agencies. Job Description: Case management of U.S. visa and permanent residency processes including H-1B - cap filings, transfers, amendments and extensions L-1s - new and extensions for locally hired employees Green Cards PERMs EB1-Cs and other categories as needed TN, E-3, H-3, J-1 waiver process and other categories as needed Partner with internal stakeholders to build F-1 OPT, OPT STEM extension...

The Benefit Contract Analyst is responsible for the design, development and maintenance of benefit documents that effectively communicate to the member the intent of the benefit design and also safeguards the company from legal exposure or liability. The incumbent collaborates with internal departments including Product, Legal, IT, Compliance, Sales, Account Management, Communications, Network, and governmental agencies.Qualifications:Bachelor's Degree or equivalent combination of education and experience required3+ years of benefit, insurance or healthcare experience requiredSelf-Insured experience preferredERISA and Non-ERISA knowledge preferredKnowledge of insurance contract, health insurance or managed care products, HMO, or health insurance benefit design requiredExperience in contract analysis and drafting or product development and management requiredExcellent understanding and working knowledge of benefits, policies and state regulatory compliance requirement required Equal...

Lead the Actuarial Pricing Team, which supports E business units in efforts to achieve their IOI goals by ensuring all actuarial needs of the business units are met or exceeded. Ensure all actuarial work complies with UHC risk management policies and procedures, and is in compliance with all relevant Actuarial Standards of Practice, as publish by the American Academy of Actuaries. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Support E P business owners and regional leaders in achieving their financial objectives. Primary areas of support include: Reviews (frequency may vary by market segment) of premium base rate adequacy for all E insured products. Communicate recommended rating actions to market-level leadership. File and obtain needed regulatory approvals for needed premium rate changes Establish consistent rating policies, procedures and methodologies across all markets Maintain UHC's...

Are you eager to make an impact on one of the most important and underserved issues in the US healthcare system? UnitedHealth Group Ventures is on a mission to protect patients from surprise bills by building a revolutionary consumer protection business. This new business will be dedicated to helping patients understand and mitigate the unexpected financial risks they face. As an employee of this new business, you can expect to be a part of a dynamic organization that is fast-paced and driven by our vision to promote healthcare affordability and accountability nationwide.The Digital Product Director will oversee the lifecycle of authenticated patient and provider portals for Naviguard. The role requires a range of skills from market and customer research, data analysis, user experience expertise, and a strong product management background. In collaboration with key stakeholders, the Digital Product Director is responsible for the overall vision of the digital product and managing...

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) The Healthcare Economics Consultant is responsible for completing claims repricing and other financial analysis to support sales opportunities throughout UHC. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Completing claim repricing analysis and provide other network data support in response to employer Sales Requests for Proposals Provide feedback and make recommendations to improve workflows Responsibility to appropriately document process and workflows Be able to provide peer review to various reports for other analysis Staying engaged...

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) As a Contract Recruiter, you will be responsible for the recruitment of candidates across a broad spectrum of roles within United HealthCare. Our Recruiters are Talent Advisors who lead the end-to-end recruitment process and are accountable for talent sourcing and selection, consulting with Hiring Managers throughout the hiring process, providing detailed assessments for candidates, developing and managing talent pipelines and managing the offer and hiring process. This role reports directly to a Talent Acquisition Manager. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary...

If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work.(sm) For this role, you will be part of the Operational Excellence and Issue Management team as a Data Quality Specialist within the Medicare Star Data Management and Reporting organization. You will be accountable for ensuring our business operations provide stellar, efficient, and scalable service, including but not limited to issue management, to internal customers while ensuring operational excellence and continuity. You'll enjoy the flexibility to telecommute* from anywhere within United States as you take on some tough challenges. Primary Responsibilities: Contribute as a Data Quality Specialist on a team that is responsible for the integrity of the data in reports and for client operations to a portfolio of Data Management and Business...

Think of this as a triple play. You have Fortune 5 global operations. You have a complex, matrix organization with dozens of interrelated business units. And you have a fast-paced, intense culture where everyone is pushing the envelope. Now, you can step into this challenge and help create new business process solutions that raise the performance of our health care system for years to come. As a Business Process Analyst, you'll be in the driver's seat on vital projects that have strategic importance to our mission. If you're ready to play in the big leagues, it's your move. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: • Create, control and improve end-to-end business processes • Lead process design and project implementation teams in process improvement activities • Create quality reporting, analysis and audits for developing plans and programs to support continuous quality improvement •...

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) UnitedHealthcare is dedicated to helping people live healthier lives and to make the health system work better for everyone. Help us achieve this powerful mission by joining the Government Programs Voice of the Customer (VOC) team as we shed light on our member's expectations, needs, and preferences. Data is at the heart of what we do. We use the power of analytics, Natural Language Processing (NLP), and resources from our research partners to aggregate and distribute insights in a repeatable, governed process. All with the intention of understanding our members better and helping to deliver a better member experience. This Senior VOC Data Manager...

UnitedHealth Group is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) We are looking for an energetic candidate to join our growing world class digital communications team. In this role, you will be responsible for managing content across multiple digital channels, partnering with communicators, engineers and designers from across the enterprise as well as prioritizing channel features to meet the organization's goals. You'll enjoy the flexibility to telecommute* from anywhere within United States as you take on some tough challenges. Primary Responsibilities: Own the creation, prioritization and delivery of actionable communication channel roadmaps in alignment with product and company needs with a...