Claims Quality Analyst

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.

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 health care system is still evolving at a rapid pace. Technology is driving new advances in how patient care is delivered and how it’s reimbursed. Now, UnitedHealth Group invites you to help us build a more accurate and precise approach to claims adjudication. In this role, you’ll be responsible for all aspects of quality assurance within the claims job family. That includes assisting, educating, problem-solving and resolving challenging situations to the best possible outcomes. Join us and build your career with the industry leader.

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 8:00 am – 5:00 pm. It may be necessary, given the business need, to work occasional overtime.

We offer 2 weeks of on-the-job training. The hours of training will be aligned with your schedule.

 

Primary Responsibilities:

• Review, research, investigate and audit claims and provide feedback to team members on audit results
• Analyze and identify trends and provide feedback and reports to reduce errors and improve claims processes and performance
• Analyze information and utilize to build recommendations to reduce errors and improve process performance
• Create, maintain and track reports in relation to performance

 

This is a challenging role with serious impact. You’ll be providing a senior level of support and subject matter expertise within a fast paced, intense and high-volume claims operation where accuracy and quality are essential.

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 analyzing and solving customer problems 
• 1+ years of working experience in claims processing or quality
• Moderate proficiency with computer and Windows PC applications
• Intermediate level of Microsoft Excel (data entry, sorting/filtering, pivot tables)
• Intermediate level of Microsoft PowerPoint (create and edit presentations)
• Flexibility to work any of our 8-hour shift schedules during our normal business hours 8:00 am – 5:00 pm.

 

Preferred Qualifications:

• Project coordination/management experience regarding claims payment and healthcare projects
• Experience utilizing FACETS claim platform 
• Process improvement experience
• Six Sigma Methodology experience (Green – Black Belt)

 

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

 

*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 $23.41 – $41.83 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.