About UHG

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:

Information Technology



Approximate Salary:

Not Specified

Position Type:

Full Time

Medical Claims Rep - Contract to Hire - Eden Prairie, MN

UHG - Eden Prairie, Minnesota

Posted: 11/9/2018

Health care leaders turn to Optum Advisory Services (OAS) for guidance, insights and practical strategies to help assert control over their organization’s future. We are more than just consultants. We are also operators with real-world health care experience, which helps clients hardwire and sustain more meaningful results that would otherwise not be achievable. As integrators across Optum, we deliver unique client-focused strategies and impact. Our proven track record driving success across the entire health care continuum empowers clients to grow, thrive and disrupt.


As part of our elite team, you will play a pivotal role in the system development cycle and consult with end users to evaluate business requirements into design specifications. You will work with all levels of the business, ensuring IT deliverables align with business requirements, with measurable results. There's never been a more exciting time to work in health care where performance and innovation can fuel your life's best work.(sm)


We are seeking a motivated individual to join our team as a Medical Claims Representative.


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 or GED

  • 2+ years with 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

  • Proficient with Microsoft Excel V-lookups

  • Medical coding/billing/CPT Codes experience

  • Knowledge of UNET/NDB, iDRS/EDSS and/or ppoONE

  • MS Office software experience

  • Well organized with ability to multitask in a fast-paced environment

  • Experience managing to deadlines

  • Excellent written and verbal communication skills

  • Self-driven, ability to work independently and facilitate change

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world’s large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)


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.



Job Keywords:  Medical Claims Adjudication; Medical Claim Customer Service; Claims; Hospital Claims; Coordination of Benefit (COB);  Explanation of Benefits (EOB);  Excel;  Data Analysis, Eden Prairie, MN, Minnesota


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