Claims / Encounter Administrator – Remote in Idaho

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 Claims / Encounter Administrator is responsible for conducting root cause analyses of claims and encounter data to track and trend claims denials, underpayments, claims errors, and provider education. The Claims / Encounter Administrator will engage with providers, one-on-one or in group settings, to educate them on appropriate claims submission processes and requirements, coding updates, and common billing errors to reduce claims denials and assists providers in getting reimbursed timely and accurately. The Claims / Encounter Administrator’s work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. 

This is a fast-paced working environment that requires the ability to multitask with attention to detail and excellent organizational skills.

If you are located in Idaho, you will have the flexibility to work remotely* as you take on some tough challenges. 

Primary Responsibilities: 

The Claims / Encounter Administrator roles and responsibilities include: 

• Conducts training with providers or groups of providers and their staff on claims denials, and/or underpayments based on trended provider claims / encounter issues and common claims / encounter errors
  
• Partners with Provider Education & Outreach Representatives to ensure prompt resolution of provider inquiries
  
• Assists with development of provider bulletins or training documents related to common claims and encounter issues and billing inaccuracies
  
• Attends association and or state lead meetings where providers can ask questions specific to claims / encounters
  
• Services as Subject Matter Expert on state performance and regulatory reports regarding claims and encounters
  
• Monitors claims trends for quality improvement opportunities and communicates with leadership on findings
  
• Monitors providers post-training to ensure the issues causing the denials are resolved
  
• Generates reports and provides health plan leadership insight into claims related trends, patterns, and causes
  

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: 

• 2+ years working in the healthcare industry such as in a provider setting or insurance company
• 2+ years of medical claims / encounter experience such as billing, claims processing, or provider customer service
• 1+ years of customer-facing experience
• General knowledge of claims coding and or dispute resolution
• Beginning to intermediate experience in Microsoft Office applications
• Ability to commute to the UHC location with a potential in-office work requirement on occasion
• Ability to work Monday – Friday and flexibly outside core hours, including evenings and weekends, per business needs 
• Resident of Idaho

Preferred Qualifications:  

• Experience with Medicaid and/or Medicare
• Experience with claims systems, adjudication, submission processes, coding, and/or dispute resolution

 

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

The salary range for this role is $71,600 to $140,600 annually based on full-time employment. 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.

 

 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.