Provider Reimbursement Specialist

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.  

The more you do, the more you learn. And as you learn, you find new doors opening that challenge you to bring your best. The Provider Reimbursement Specialist role with UnitedHealth Group will call on your knowledge, your energy and your commitment to making healthcare work more effectively for more people. We’re driving ever higher levels of sophistication in how provider networks are composed and compensated. You’ll be part of a team that’s out to assist company affiliates with initial deployment and ongoing support of systems and processes that leverage contracted national network rates and policies. Join us and you’ll discover the resources, backing and opportunities that you’d expect from a Fortune 6 leader.

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

Primary Responsibilities:

• Implement programs designed to ensure proper application of contracted rates and reimbursement policies for company affiliates
• Perform analysis of claims, pre and post payment, to ensure proper pricing of contracts, reimbursement policies and procedures
• Review claim disputes to verify correct pricing and analyze claim inquiry data to determine root cause of errors and recommend system changes, training and process improvements to prevent future errors
• Identify and solve a range of problems within area of expertise
• Investigate non-standard requests and problems
• If you are looking for a challenge, this fast-paced, performance driven team environment is the place to be. You’ll be expected to provide analytical expertise and accurate direction on pricing while meeting aggressive production goals

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 higher) 
• 2+ years of experience in research, analysis and reporting
• 1+ years of experience working with reimbursement methodologies
• 1+ years of experience with MS Office (Excel, Word and PowerPoint)

Preferred Qualifications:

• Undergraduate degree
• Ability to create and conduct effective presentations

*All Telecommuters 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 $23.41 to $41.83 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 

    

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. 

    

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.

    

   

#RPO #GREEN