Payer Implementation Specialist – Remote

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

 

The Payer Implementation Specialist will provide technical expertise during the installation, implementation, and maintenance of real-time and batch services for payers. Implementation specialists will be involved in setting up customers on our tools, assisting with questions during the development period, and helping customers understand the installation specifications and requirements.

 

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

 

Primary Responsibilities:

• Creates project plans, task lists, detailed work plans to drive a new client start-up to completion that will involve client, operations, IT and hitting revenue goals
• Regular and proactive meeting cadence established to drive deliverables of project
• Frequently interacts with internal/external customers and/or functional peer groups
• Utilize proprietary applications, tools, and processes to implement and deploy solutions
• Setting up product access and permissions for customer user groups
• Understand customers business needs and translate them into operational requirements
• Responsible for set-up of customer data files primarily related to 837 (Claims), 835 (Remit/ERA).  May need to engage in 270/271 Eligibility, 276/277 Claim Status, and 275 (Medical Attachments)
• Identifies and proposes resolutions for systems issues or changes that impede timely and accurate Revenue Cycle services
• Coordinate with customer IT personal to set-up and configure product solutions
• Responsible for product testing and resolution of product configuration issues during Implementations
• Troubleshooting and resolving technical issues encountered by customers
• Effectively respond to changing product, project and customer demands while balancing multiple ongoing projects
• Coordinate with product development team in identifying and resolving product bugs delaying implementations
• Create documentation to document processes/procedures for tasks that are completed by the Implementation team

 

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:

• 5+ years of customer-facing experience in:
  • Customer integrations/implementations
  • Software system delivery and training
  • Project management
• 5+ years of experience with X12 and clearinghouse operations in two or more of the following areas: Claims, ERAs, Eligibility, Referrals, Attachments, and Authorizations
• 1+ years of experience with Payers
• Advanced level of proficiency in Microsoft Office & Windows OS

 

Preferred Qualifications:

• 5+ years of experience in a technical implementation, project management, operations management and/or training role
• Project management and process improvement experience
• Familiarity with file transfer protocols, specifically sFTP
• Experience reading the TR3 Guide, ANSI, and HIPAA compliance
• Ability to work with large amounts of data, including checks for integrity, summation, and effective communication (written and verbal) to internal and external constituents

 

Soft Skills: 

• Excellent communication, written and verbal skills
• Effective at leading time effective coordination meetings

 

*All employees working remotely will be required to adhere to UnitedHealth 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). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $71,200 to $127,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

Application Deadline: 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 UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes – an enterprise priority reflected in our mission.

 

 

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

 

UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.