- Auditing contract loads for adherence to quality measures and reporting standards
- Researching errors by comparing Account Management documentation against multiple internal systems
- Analytical and Researching techniques to trend or quantify projects
- Preparing, processing, and maintaining new group installation and renewals
- Responding to member eligibility or group questions and verify enrollment status
- Reconciling reports and group set up discrepancies, as well as analyzing transactional data and submitting retroactive eligibility changes
- Research and respond to all claims processing inquiries from Client Management, Clinical, and other internal departments
- Perform claim testing to ensure accurate claim adjudication
- Conduct installation of assigned accounts, including, but not limited to: structure building and billing set up, structure revisions, researching and resolving structure issues, database loading, and preparation of plan materials such as administrative documents and customer education material
- Overall employer contract loading using various databases and / or source documents
- May research installation issues and develop customer specific resolutions which may include auditing contract loads for adherence to quality measures and reporting standards
- Utilize Facets claims processing system
- Perform other duties as assigned
- High School Diploma / GED or higher
- 1+ years of experience in a healthcare insurance environment using the telephone and computer as the primary instruments to perform job duties
- 1+ years of Facets experience
Physical Requirements and Work Environment:
- Frequent speaking, listening using a headset, sitting, use of hands / fingers across keyboard or mouse, handling other objects, and long periods working at a computer
- Service center environment with moderate noise level due to Representatives talking, computers, printers and floor activity
Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Keywords: Employee; Installation; CSR; Customer Service