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Careers at UnitedHealth Group

 

We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM

 

Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com

 

Job Category:

Claims

Country:

US

Approximate Salary:

Not Specified

Position Type:

Full Time

Medical Claims Quality Analyst - Eden Prairie, MN

UHG - Eden Prairie, Minnesota

Posted: 12/7/2018

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making Healthcare data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life’s best work.


We are seeking a motivated individual to join our team as a Medical Claims Quality Analyst. Positions in this function are responsible for providing expertise in claims / EOB knowledge.

Individuals in this position will review and analyze data, present information related to facility claim information in an attempt to identify trends, competitor reimbursement and contract practices. Individuals will also contribute to development and implementation processes and business solutions through research and analysis of data.

Primary Responsibilities:

  • Use pertinent data and facts to identify and solve a range of problems within area of experience
  • Understand and interpret explanations of benefits (EOB) data from variety of carriers in a variety of formats
  • Basic analysis and investigation of trends in the data and competitors product and rates
  • Retrieve and interpret claim reports to assist with efficient and accurate documentation of claims for delivery to internal and external customers
  • Research, identify and obtain data / information needed to help accurately interpret the data as needed
  • Provide feedback to co-workers through peer review process
  • Anticipate customer needs and contribute to proactive identification of solutions
  • Other duties as deemed appropriate to provide a quality, timely product for delivery to our customer


Required Qualifications:

  • High School Diploma / GED (or higher)
  • 2+ years medical claims adjudication and / or medical claim customer service experience with exposure to Coordination of Benefit (COB) and / or interpretation of Explanation of Benefits (EOB)
  • 1+ years of data analysis experience (finding trends in data including plans, products and network rate differentials)
  • Proficient with Microsoft Excel (basic formulas, sorting, filtering and formatting)
Preferred Qualifications:

  • Associate’s Degree (or higher)
  • Medical coding, billing, CPT Codes
  • Knowledge of UNET / NDB, iDRS / EDSS and / or ppoONE
Soft Skills:
  • Well organized with ability to multitask in a fast-paced environment
  • Experience managing deadlines
  • Excellent written and verbal communication skills
  • Self-driven, ability to work independently and facilitate change
Careers with OptumInsight. Information and technology have amazing power to transform the Healthcare industry and improve people's lives. This is where it's happening. This is where you'll help solve the problems that have never been solved. We're freeing information so it can be used safely and securely wherever it's needed. We're creating the very best ideas that can most easily be put into action to help our clients improve the quality of care and lower costs for millions. This is where the best and the brightest work together to make positive change a reality. This is the place to do 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: Eden Prairie, MN, Optum, Medical Claims, medical claims adjudication, medical claim customer service, Coordination of Benefit, COB, Explanation of Benefits, EOB

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