No Surprises Act Negotiator

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.

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

The NSA Negotiation Specialist represents ClearHealth’s clients during the 30 Day Open Negotiation period for the Federal No Surprises Act. Using available guidelines and system tools, the specialist will communicate with providers professionally to determine the appropriate payment and in a set timeline. This includes responding to incoming calls and making outbound calls as required, ability to work independently, and follow defined standards and procedures. Will provide training for this position.

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 8am – 5pm. It may be necessary, given the business need, to work occasional overtime.

                                        

Primary Responsibilities:

• Ensure appeal has been categorized correctly
• Obtain additional documentation required for case review
• Render decisions for non-clinical complaints using sound, fact-based decision making
• Complete necessary documentation of final appeals determination using appropriate templates
• Communicate appeal information to providers and internal/external parties within the required timeframes
• Manage a high volume of negotiations by working in a system queue
• Evaluate and negotiate claims in accordance with established surprise billing laws
• Speak to healthcare providers about how a claim was priced given a client’s defined business rules
• Manage inbound and outbound telephone calls from providers using a softphone

                                        

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:

• High School Diploma / GED OR equivalent work experience
• Must be 18 years of age OR older
• 1+ years of experience with insurance claims, billing or eligibility verification within a healthcare setting
• Proficiency with computer applications, which includes the ability to navigate and learn new and complex computer system applications
• Ability to work any of our 8-hour shift schedules during our normal business hours of 8:00am – 5:00pm

                                       

Preferred Qualifications:

• 1+ years of medical billing & coding experience
• 1+ years of experience processing claims
• Experience with No Surprise Act
• Appeals experience

                                       

Telecommuting Requirements:

• 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 UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

                                       

Soft Skills:

• Ability to manage multiple priorities in a time sensitive manner
• Strong verbal communication and relationship management skills
• Ability to meet deadlines and establish appropriate priorities
• Manages workload, works efficiently, meets goals and objectives
• Ready to work, ready to learn attitude
• Honest, accountable, maintains confidentiality

                                       

*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 hourly pay for this role will range from $20.00 – $35.72 per hour 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.

                                       

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