UMR Stop Loss Collections Representative

UMR, UnitedHealthcare’s third-party administrator (TPA) solution, is the nation’s largest TPA. When you work with UMR, what you do matters. It’s that simple . . . and it’s that rewarding.

In providing consumer – oriented health benefit plans to millions of people; our goal is to create higher quality care, lower costs and greater access to health care. Join us and you will be empowered to achieve new levels of excellence and make a profound and personal impact as you contribute to new innovations in a vital and complex system. Opportunities are endless for your career development and advancement within UMR due to our record-breaking growth.

Regardless of your role at UMR, the support you feel all around you will enable you to do what you do with energy, quality, and confidence. So, take the first step in what is sure to be a fast – paced and highly diversified career.

This position is onsite full-time. Employees are required to have the ability to work an 8-hour shift schedules during our normal business hours of 7:00 AM – 5:00 PM CST including the flexibility to work occasional overtime (if approved / offered) based on business need. The office is located at 115 West Wausau Ave, WI 54401

We offer on-the-job training. The hours of the training will be aligned with your schedule.

      

Primary Responsibilities:

• Collect and sort mail items 3x per day  
• Copy and categorize checks for regular mail or express mail distribution  
• Update check amounts in a tracking database  
• Provide Group Mailbox ad-hoc reporting support  
• Run ad-hoc and monthly production reports  
• Provide expert claims support by reviewing, researching, investigating, negotiating and resolving all types of claims as well as recovery and resolution for health plans, commercial customers and government entities.  
• Analyze and identify trends and provides reports as necessary.  
• Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance.  
• Develop information sources to complete weekly claim filings for Stop Loss.  
• Recording reimbursements received.  
• Provide for follow – up requests from Stop Loss Carriers.  
• Develop understanding of Stop Loss and Plan Sponsor Policy and Contract language and the relationship this has to Claim Filings.  
• Solicit requirements from several sources including Claim Systems, Reporting Systems, direct contacts with Claim and Eligibility Teams, and direct contact with Providers.  
• Provide insights on claim issues.  

       

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 analyzing and solving customer problems  
• Experience with Microsoft Excel (creating spreadsheets), Microsoft Word (creating documents) and Microsoft Outlook (drafting emails, calendar management).
• Must reside within 25 miles of the office located at 115 West Wausau Ave, WI 54401
• Ability to work onsite full-time. Employees are required to have the ability to work an 8-hour shift schedules during our normal business hours of 7:00 AM – 5:00 PM CST including the flexibility to work occasional overtime (if approved / offered) based on business need.

    

Preferred Qualifications:

• 1+ years of experience processing claims
• Current or previous experience with UMR CPS / Jacada system
• Experience within the Healthcare industry  

     

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.

    

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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