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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:




Approximate Salary:

Not Specified

Position Type:

Full Time

Recovery Resolution Analyst (Healthcare/Claims) - Ontario, CA

UHG - Ontario, California

Posted: 12/13/2018

The Recovery Resolution Analyst is responsible for the Healthplan and Provider billings, claims auditing, recovery and resolution of claims issues in conjunction with other functions within the Revenue Recovery department.
Primary Responsibilities:
  • Responsible for the submission of  the Healthplan and Provider billings in a timely manner
  • Generate and  review all relevant claims data from the specified System
  • Ability to analyze data and automate the current processes to make them more efficient
  • Provide claims expertise support by reviewing, researching, investigating, negotiating, and resolving all types of claims issues
  • Process Refund Checks and Debit Offsets and post recoveries to applicable System
  • Reconcile the submissions & recoveries data and follow-up on outstanding Accounts
  • This candidate is expected to work with the Revenue Recovery Team to identify and facilitate the Healthplan and Provider billing and recovery operations
  • Actively participate in all aspects of the Revenue Recovery functions as needed
  • Assist the Lead of the department with the  month-end financial report
  • Perform other duties as assigned

Required Qualifications:
  • High School Diploma or GED
  •  5-8 years of working experience in Managed Health Care with emphasis in the following areas:
    • Claims Data Analysis
    • Healthplan and Provider Billings
    • Interpretation of Healthplan DOFRs and Provider Contracts
    • Reconciliation of Billing and Recovery data
  • Strong analytical and problem solving skills coupled with strong attention to detail
  • Intermediate  proficiency in Microsoft Excel and Access with working knowledge of SQL
Preferred Qualifications:
  • Experience working with high volume of claims data
  • Knowledge and experience in ICD-10 and HCPC coding
  • Exceptional written and oral communication skills
  • Capable of working with minimal supervision exercising independent judgment within the scope of knowledge.

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system 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: Claims Data Analyst, Managed Care, Healthcare, Provider billing, DOFR, Provider Contract, Excel, Access, HCP-10, HCPC coding, Ontario, CA, California

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