Senior Claims Business Process 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. 

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. 

Senior Claims Business Process Analyst – This position will be assigned to ClearHealth Strategies’ Independent Dispute Resolution (“IDR”) team. You    will work with the IDR team in a quasi-legal process to assist in the review of disputes, eligibility analysis, and preparation of arbitration briefs in support of ClearHealth’s compliance with the federal No Surprises Act and state surprise billing laws. Using available state and federal guidelines, you will be an essential contributor throughout the IDR process, with focus on briefing and submission of documentation to an independent arbiter. You will be expected to cogently respond to requests from CMS, independent arbiters, providers, clients, management, and other individuals throughout the day. Candidates should have the ability to work independently and follow defined standards and procedures with efficiency and accuracy. 

This position is full time (40hours/week) Monday – Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am -5:00pm. It may be necessary, given the business need, to work occasional overtime.

   

Primary Responsibilities: 

• Prepare arbitration briefs 
• Respond to inquiries from CMS, arbiters, providers, clients, and ClearHealth management 
• Identify issues, analyze EOBs and claims information, apply critical thinking skills to formulate plan of action, and resolve issues independently 
• Triage complex issues to management 
• Manage multiple priorities in a time sensitive manner 
• Work in fast-paced, high-volume environment with quick turnaround time 
• Communicate effectively utilizing solid business writing skills 
• Prioritize and manage workload to meet deadlines, goals, and objectives 
• Collaborate with coworkers in cohesive team environment 
• Ready to work, ready to learn mindset 
• Integrity, accountability, and ability to maintain confidentiality

   

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 
• 2 + years of legal experience either in a law firm or in-house legal department
• Experience ensuring compliance with HIPAA privacy and security regulations 
• Ability to work full-time between 8:00 am – 5:00 pm local time, including the flexibility to work occasional overtime given the business need.

   

Preferred Qualifications:  

• 1+ years of experience in the federal No Surprises Act (NSA) and/or state surprise billing disputes 
• Insurance claims, medical billing and/or health insurance industry experience  
• Experience in Personal injury litigation 
• Knowledge of medical claims process.

    

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 salary 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.

   

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