Welcome to one of the toughest and most
fulfilling ways to help people, including yourself. We offer the latest tools,
most intensive training program in the industry and nearly limitless
opportunities for advancement. Join us and start doing your life's best work.
Positions in this function are responsible for recovering and resolving all types of overpayments to providers as well as recovery and resolution for health plans, commercial customers and government entities. This entails initiating telephone calls to providers and discussing the overpayment situations with the right party point of contact. We need to progress the overpayment situation, move up the ladder and speak to all imperative parties to secure a refund or resolve the overpayment. It is our responsibility to address any issues or concerns and resolve barriers prohibiting our ability to recover the overpaid dollars. Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance.
- Owns output at task level
- Work is generally limited to own function
- Sets priorities for the team to ensure task completion
- Coordinates work activities with other supervisors
- Develops plans to meet short-term objectives
- Identifies and resolves operational problems using defined processes, expertise and judgment
- Decisions are guided by policies, procedures and business plan
- Product, service or process decisions are most likely to impact individual employees and/or customers (internal or external)
- Bachelor's degree (or higher) or 5+ years of equivalent experience
- 5+ years of experience in Medical Claims/Insurance, Professional Billing, and / or Collections
- 5+ years of experience analyzing and solving customer problems
- 5+ years of experience working in the health care industry
- Medical healthcare terminology
- Experience using 2 or more of the following Claims Platforms: ODAR, UNET, COSMOS, CPW, ISET, NICE, FACETS, CSP, and / or Oxford
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: Overpayments, Medical Claims, Collections, Billing, UHG, United Health Group, UHG