Claims Adjustment Representative

UnitedHealth Group - Phoenix, AZ

Energize your career with one of Healthcare’s fastest growing companies.

You dream of a great career with a great company – where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it’s a dream that definitely can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.

This opportunity is with one of our most exciting business areas: Optum – a growing part of our family of companies that make UnitedHealth Group a Fortune 5 leader.

Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.

Positions in this function are responsible for providing expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting claims. Authorizes the appropriate payment or refers claims to investigators for further review. Conducts data entry and re - work; analyzes and identifies trends and provides reports as necessary.

Primary Responsibilities:
Consistently meet established productivity, schedule adherence, and quality standards
Moderate work experience within own function
Some work is completed without established procedures
Basic tasks are completed without review by others
Supervision / guidance is required for higher level tasks

Required Qualifications:
High School Diploma / GED (or higher)
1+ years of experience in an office setting environment using the telephone and computer as the primary instruments to perform job duties
1+ years of experience with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
1+ years of experience with claims adjustments using CSP Facets to perform underpayment, over payment adjustments and generate overpayment letters
Experience processing and adjusting claims by applying deductibles, copay, tiered copays, coins and out of pocket calculations
Experience processing and adjusting claims using macros
Experience in processing and adjusting claims according to the standard operating procedure, policies and job aid
Experience in processing and adjusting claims related to medical and behavioral different level of Care and Services

Preferred Qualifications:
1+ years of experience with Microsoft Excel (data entry)
10 - key data entry experience
Ability to type 35+ WPM

Soft Skills:
Effectively communicate verbally and written
Strong Attention to detail

Physical Requirements and Work Environment:
Extended periods of sitting at a computer and use of hands / fingers across keyboard or mouse
Office environment
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.