Senior Claims Business Process Analyst
UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.
Position Description:
Flexible, Friendly, Fast on your feet, That's a great start. Accurate, Accountable, Self Directed, These traits can take you places. Our claims operations are the focal point of handling information about services patients receive and they way those services get paid. It's complex, detailed work. It's fast paced challenge. It's a job that calls on you to be thoughtful, resourceful, team-driven and customer-focused. To put it mildly, there is never a dull moment.
Primary Responsibilities:
- Escalation point for unresolvable issues.
- Support for upcoming internal or external claim audits .
- Facilitation of upstream defects or cross functional issues impacting claims payment .
- Supporting the Sites to ensure all internal Claim metrics and PGs are met on an ongoing basis.
- New Business implementation
- Claim Site Transitions
- Claims related and business system analysis
- Responsible for all aspects of quality assurance
- Create and edit requirements, specifications, cost benefit analysis and recommendations to proposed solutions
- Facilitate development of process documentation
Requirements:
- Bachelor's Degree OR a high school diploma with 4+ years of relevant work experience
- 3+ years of Claims Processing/COSMOS Claims Operations experience
- 1+ year of advanced MS Word and Excel Experience
- 1+ year of Public Sector experience
- Must be able to travel when necessary; 25% travel within in the U.S.
Assets:
- Experience with UAT is a plus
- SharePoint experience is strongly desired
- Understanding of Macros Express is preferred
- Root Cause Analysis experience highly preferred
OptumHealth is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.
OptumHealth helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their health care needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation Performance.
At OptumHealth, you will perform within an innovative culture that's focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that's greater than you've ever imagined.
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
Additional Information:
- Travel Percentage: 25%
