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Healthcare EDI Coordinator - Ontario, CA (742049)

Position Description

Primary Responsibilities:

  • Identify and resolve new or unusual EDI claims errors / issues as they arise, using established procedures
  • Achieve applicable performance metrics (e.g., productivity, quality, TAT)
  • Use appropriate documentation, reference materials and/or websites to ensure that EDI claims are processed accurately and efficiently
  • Collaborate with operational partners to help complete claims processing workflows
  • Generate and distribute reports as required
  • Learn and use new systems / applications / resources as needed
  • Comply with Applicable Laws, Regulations and Policies
  • Ability to apply knowledge / skills to basic, repeated activities
  • Knowledge of UB92 and CMS1500 form layouts
  • Ability to carry out assignments with thoroughness, accuracy and attention to detail
  • Strong organization and prioritization skills
  • Respond in a timely manner to customer requests and concerns
  • Ability to make logical fact-based decisions

Required Qualifications:

  • 1+ years of experience in a related environment (i.e. office, administrative, clerical, etc.) using phones and computers as the primary job tools

  • Customer Service Experience

  • Moderate Proficiency with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications

Preferred Qualifications:

  • High school diploma or GED OR 1+ years of equivalent working experience

  • Experience with UB92 and CMS1500 form layouts

  • Experience with EDI Claims

  • Ability to understand multiple processing rules to ensure timely delivery for transactions

 

 

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)

 

 

North American Medical Management, California, Inc. (NAMM California) partnered with OptumHealth in 2012. NAMM California and OptumHealth share a common goal of bringing patients, physicians, hospitals and payers closer together in the mission to increase the quality, efficiency and affordability of care. NAMM California is a part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system. NAMM California develops and manages provider networks, offering a full range of services to assist physicians and other providers in supporting patient care coordination and their managed care business operations. For over 18 years, NAMM California has been an innovator in health care with a track record for quality, financial stability, extraordinary services and integrated medical management programs. NAMM California is well positioned to continually invest in its infrastructure and systems for the benefit of its provider clients and to accommodate the impending changes that will come forth from healthcare reform.

 

The NAMM California provider clients represent a network of almost 600 primary care physicians and over 3,000 specialists and work with the premier hospitals in their respective markets.

 

 

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.

 

 

Job Keywords: Healthcare, EDI, ANSI, UB92, CMS1500, Ontario, CA, California

Job Details

  • Contest Number742049
  • Job TitleHealthcare EDI Coordinator - Ontario, CA
  • Job FamilyClaims
  • Business SegmentOptumCare

Job Location Information

  • Ontario, CA
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelIndividual Contributor
  • ShiftDay Job
  • TravelNo
  • Telecommuter PositionNo
  • Overtime StatusNon-exempt