It’s that time, isn’t it? You’re ready for the next step forward and an opportunity to build on your skills. And it just so happens that there’s never been a better time to become a part of the team at UnitedHealth Group. We’re driving even higher levels of sophistication in how provider networks are formed and operate. The goal is to improve quality of service while exploring new ways to manage costs. Here’s where you come in. You’ll use your knowledge of insurance claims and customer service to help create strong relationships with the providers in our networks. As you do, you’ll discover the resources, backing and opportunities that you’d expect from a Fortune 6 leader.
- Assist in end-to-end provider claims and help enhance call quality
- Visit several of our markets, retrieve orders, and educate the physicians and their patients
- Have some knowledge of paperwork involved in getting patients to be approved for their medical services and their medical equipment
- This person should be able to understand the medical components of home health, as well – understand the medical necessity of patients, as it applies to their diagnosis – whether it be a hospital bed, oxygen use, rolling walker, hand canes
- Assist in the design and implementation of programs that build/nurture positive relationships between the health plan, providers and practice managers
- Support development and management of provider networks
- Help implement training and development of external providers through education programs
- Identify gaps in network composition and services to assist network contracting and development teams
Taking a giant leap step forward comes with great challenge. You’ll ensure provider service quality by making outbound calls to obtain data and verify information with providers as well as perform analysis and develop reports that help clarify operational issues and opportunities.
- High school diploma or equivalent work experience
- Have working knowledge of paperwork involved in getting patients to be approved for their medical services and their medical equipment
- Must understand the medical components of home health, as well – understand the medical necessity of patients, as it applies to their diagnosis – whether it be a hospital bed, oxygen use, rolling walker, hand canes
- 2+ years of managed care or medical insurance experience
- 1+ years experience in a claims, customer service or provider support role
- Proficiency with MS programs including Excel and Word
- Speak Spanish Fluently
Proven oral communication skills including telephone etiquette
Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 240,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team 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: Claims, McAllen, Texas, TX, Rio Grande Valley