- Assist with escalated claims to resolve complex issues for team members and internal customers
- Support implementation of updates to the current procedures and assist with new system training/mentoring
- Review guidelines as well as benefit plan documents and certificates to ensure proper benefits have been applied to each claim
- Analyze and identify trends and provides reports as necessary
- 3+ years of experience in a related environment (i.e. office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools
- 1+ years experience processing medical, dental, prescription or mental health claims
- An education level of at least a high school diploma or GED OR equivalent years of work experience
- Proficiency with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications
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: Healthcare, health care, Managed Care, Billing Representative, Billing, Collections, Claims, Customer Service, Medical Billing, Senior Claims Examiner, Claims Examiner, Claims Processor