Associate Recovery Resolution Representative – National 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.

Positions in this function are responsible for investigating, recovering and resolving all types of claims as well as recovery and resolution for health plans, commercial customers and government entities. May include initiating telephone calls to members, providers and other insurance companies to gather coordination of benefits data. Investigate and pursue recoveries and payables on subrogation claims and file management. Process recovery on claims. Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance. May conduct contestable investigations to review medical history. May monitor large claims including transplant cases.

This position is full time, Monday – Friday. Employees are required to have flexibility to work our normal business hours of 8:00am – 5:00pm EST. It may be necessary, given the business need, to work occasional overtime.

We offer 4 weeks of on-the-job training. The hours of the training will be during normal business hours.

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

 

Primary Responsibilities:

• Open, sort, date stamp, count, scan and document in case management system the receipt of file correspondence, including revenue checks. 
• Distribute correspondence to staff accordingly.
• Answer incoming phone calls in a polite and professional manner.
• Facilitate the handling of callers’ request for information.
• Route calls to other staff members; take and deliver accurate and complete messages as appropriate.
• Screen calls and initiate resolution of questions / issues without consultation with others.
• Respond timely to all questions from assigned team members and management about internal process and procedures.
• Provide continuous availability for questions and assistance (70%)
• Provide ongoing coaching and development to ensure peak performance.
• Handle escalated calls; anticipate customer needs and proactively develop solutions to meet them.
• Mentor team members by completing side – by – side training.
• Research and provide guidance regarding applicability of laws, regulations and other requirements to cases, contracts, or decisions.
• Prepare and facilitate ongoing training opportunities for assigned team members. 
• Provide or seek settlement authority in accordance with internal policy / guidelines and client expectations.
• Perform oversight on work completed by assigned team members monthly to ensure understanding of department policies and procedures.
• Deliver oversight results to assigned team members (15%)
• Identify trends and impacts to our business and resolve where appropriate or bring those concerns forward to management (10%)
• Partner with management in the creation and development of team job aids to ensure the information is consistent and up to date.
• Collaborate with business partners to resolve issues impacting the business.
• Attend and participate in Team Lead team meetings by raising team concerns or questions to ensure the teams are consistent across all internal policies and procedures.
• Create and deliver client reporting as needed (5%)
• Prioritize and organize own work to meet deadlines and established objectives.
• Assist management on special projects and any other assigned tasks.

 

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
• Must be 18 years of age OR older
• 1+ years of experience within an operations support role (i.e., previous administrative background involved with performing administrative duties on a day – to – day basis)
• Proficiency with using Microsoft Word (documentation purposes) and Microsoft Excel (data entry for reporting purposes)
• Ability to work our normal business hours of 8:00am – 5:00pm EST. It may be necessary, given the business need, to work occasional overtime.

 

Preferred Qualifications:

• 1+ years of healthcare customer service
• Previous experience with medical records

 

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:

• Excellent organizational skills

 

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy  

 

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Washington, Rhode Island, OR Washington, D.C. Residents Only: The hourly range for this is $16.00 – $28.27 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

 

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.

 

 

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.

 

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