Position Description:Serve as a Report Analyst for the EWS Claim Project Management (CPM) Team. You will be accountable for requesting claim reports using instructions provided to you by the EWS CPM team and reviewing the data returned to isolate claims that have mis-paid due to provider contract set up issues, system defects, fee schedule load errors, etc. Early Warning System (EWS) is a project where a series of data driven signals, such as repeat phone calls from providers and the generation of non-adjust letters, are used to identify provider issues and systemic gaps with our int...
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The Senior Network Audit & Recovery Analyst is responsible for reviewing and analyzing medical claims data in large files to indentify overypayments and other issues. Determining root causes for various problems including contract loading issues, reimbursements and other system errors. Will perform core extracts on a monthly basis for specific business segments. Conducts internal and on-site audits of provider records, clinical records, and itemized bills so as to ensure appropriateness of billing practices and application of medical policy. I...
Position Description:The Provider Installation Representative is responsible for the installation and administration of assigned contracts, including, but not limited to: structure and billing set up, eligibility collection, database loading, and preparation of plan materials such as administrative documents and provider education materials. Provider Installation Representatives are also responsible for overall provider contract and amendment loading and processing using various databases. Responsibilities may also include auditing contract loads for adherence to quality measurers and reportin...
Position Description:The Associate Provider Installation Specialist is responsible for the installation and administration of assigned contracts, including, but not limited to: structure and billing set up, eligibility collection, database loading, and preparation of plan materials such as administrative documents and provider education materials. Associate Provider Installation Specialists are also responsible for overall provider contract and amendment loading and processing using various databases. Responsibilities may also include auditing contract loads for adherence to quality measurers ...
The Supervisor of Provider Reimbursement is responsible for developing programs, policies and strategies to ensure that contracted rates and reimbursement policies are applied accurately for company affiliates. Supervisors of Provider Reimbursement will analyze claims, pre and post payment, to ensure contracts and reimbursement policies and procedures are priced accurately; review claim disputes to verify correct pricing and analyze claim inquiry data to determine root cause of errors; recommend system changes, training and process improvements to prevent future errors; work with both internal...
What makes your Network career greater with UnitedHealth Group? Growth opportunities among the variety of product lines and making an impact on the healthcare system ensures it will always be challenging and exciting. The Network Program Consultant is responsible for the successful program design, compliance with network requirements, network assessment and selection, and program/product implementation. This includes enterprise-wide Behavioral Health Network teams that focus on processes related to market strategy to improve the quality and affordabi...
Position Description:We are in search of a self-directed claims professional with a strong work ethic to participate in the Early Warning System (EWS) Initiative. If you want to work in a position that offers challenging work and a variety of problems to solve and troubleshoot, this might be the right role for you. Early Warning System (EWS) is a project where a series of data driven signals, such as repeat phone calls from providers and the generation of non-adjust letters, are used to identify provider issues and systemic gaps with our internal processes. The ideal applicant will ...
The Provider Relations Advocate is responsible for the full range of provider relations and service interactions within UnitedHealth Group, including working on end-to-end provider claim and call quality, ease of use of physician portal and future service enhancements, and training and development of external provider education programs. Provider Relations Advocates design and implement programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.), and practice managers. Responsibilities also include directing and implementing st...
Position Description:Positions in this function are responsible for the installation and administration of assigned contracts, including, but not limited to: structure and billing set up, eligibility collection, database loading, and preparation of plan materials such as administrative documents and provider education materials. Positions are also responsible for overall provider contract and amendment loading and processing using various databases. May include auditing contract loads for adherence to quality measurers and reporting standards. UnitedHealthcare is part of the family of com...
Provider Relations Advocate - Hockessin, DE(324106)Full-time with AmeriChoice in Dover, DelawarePosted 3/31/2010
Associate Provider Installation Specialist - Cypress, CA(324902)Full-time with Prescription Solutions in Cypress, CaliforniaPosted 4/28/2010
Manager, Provider Relations Service & Advocacy - Albuquerque(325625)Full-time with AmeriChoice in Albuquerque, New MexicoPosted 5/3/2010
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