You'll join a high caliber team where you're assisting, educating, problem-solving and resolving tenuous situations to the best possible outcomes. Bring your people skills, emotional strength and attention to detail. In return we offer the latest tools and most intensive training program in the industry. Get ready to start doing your life's best work.(sm)
Positions in this function are responsible for investigating, recovering and resolving all types of claims as well as recovery and resolution for health plans, commercial customers and government entities. May include initiating telephone calls to members, providers and other insurance companies to gather coordination of benefits data. Investigate and pursue recoveries and payables on subrogation claims and file management. Process recovery on claims. Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance. May conduct contestable investigations to review medical history. May monitor large claims including transplant cases.
- 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)
- High School Diploma / GED or higher
- Intermediate level of proficiency with Microsoft Excel. (Includes the ability to create pivot tables, V Lookups, Formulas and Sum Functions)
- 1+ years of experience in the development of staff / team which includes experience coaching and mentoring direct reports
- 1+ years of experience in providing customer service in a call center environment to internal and/or external customers
- 1+ years of experience leading a group of 10 or more in the capacity of supervisor, manager, team lead
- 1+ years of experience working within the healthcare industry
- 2+ years of experience in customer service
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: Optum, Healthcare, Customer Service, Claims, Resolutions, Recovery, Supervisor