Provider Reimbursement Specialist - Remote

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.

We are seeking a Provider Reimbursement Specialist to join our team.

This specialist role with Optum, a UnitedHealth Group affiliate, will call on your knowledge, your energy and your commitment to making health care 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. 

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 enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Primary Responsibilities:

• Review email issues submitted by Skilled Nursing Facilities (SNF) and upload them into the Optum EnterpriseNow Issue Management tracking system 
• Research, analyze, identify root cause correctly the first time, and coordinate resolution of claim issues with internal business partners 
• Be accountable for accurate documentation and routing of issues to appropriate resolution partners 
• Provide feedback and education to SNFs to reduce recurrence of billing errors    
• Manage time effectively and balance workload and projects volume. The ability to prioritize, and multi-task effectively is required for success in this position 
• Monitor progress of assigned claim issues and provide regular updates to the SNF contact 
• Follow Team Standard Operating Procedures (SOP) and use Resource Guides during issue resolution 
• Report the final resolution on assigned claim issues to the SNF contact. Communication must be accurate, clear, and effective 
• Maintain compliance with all Federal/State regulations and UHG policies 
• Communicate in terms that the listener/recipient will understand

What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
• 401(k) Savings Plan, Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
• More information can be downloaded at: http://uhg.hr/uhgbenefits

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) 
• 4+ years of health care/managed care experience
• 2+ years of CSP claim processing experience
• 1+ year(s) of experience with Medicare and Medicaid regulations
• Intermediate proficiency with Microsoft Word, Excel, PowerPoint and Access
• Current CSP access upon hire 

Preferred Qualifications:

• Associate's Degree (or higher)
• CSP claims Subject Matter Expert (SME)
• CSP benefit configuration experience
• CSP claims auditing experience

*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 $28.94 to $51.63 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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