uhcprovider

  • Encrypted
    Site is Encrypted

  • Country
    Hosted in United States

  • City
    Des Moines, Iowa

  • Latitude\Longitude
    41.6021 / -93.6124    Google Map

  • Traffic rank
    #97,761 Site Rank

  • Site age
    22 yrs old

  • Site Owner information
    Whois info

Traffic rank
#97,761
Site age
22 yrs
Location
United States
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Newest job postings for uhcprovider
via ZipRecruiter posted_at: 10 days agoschedule_type: Full-timesalary: 18.80–36.78 an hourwork_from_home: 1
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doingyour life's best work.SM The... UHCProvider Reimbursement Representative-UMR - UHC Resolution At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doingyour life's best work.SM

The... UHCProvider Reimbursement Representative-UMR - UHC Resolution Teamrequires that an employee will review and respond to emails received from UHN Network Managers, UHC Provider Advocates, the Social Media Team and UMR internal employees in regard to UMR processes, procedures and results that are being challenged. These inquiries can range from claim processing challenges and contracted pricing reviews to questions about UMR plan language, authorizations, penalties, prompt pay and even legal and social media issues. Escalated Issues team members also review inquiries sent from internal UMR departments in relation to UHC provider questions and processes related to contracts. Persons in this position will need to be resourceful and able to work with the various UMR and UHC departments to be able to provide the information to resolve the inquiries, which includes phone calls to providers and UHC representatives. This position is fast paced due to TAT guarantees and candidates will be required to be thorough in their reviews and professional in their replies. Persons in this position need to work in a team environment and be able to organize and prioritize daily work tasks from inquiries received via the UMR-UHC Escalated Issues Email box, which will be the main responsibility for this role. This position will require working with multiple internal UMR and UHC departments as well as external customers and providers to identify and resolve complex issues in a professional and quality focused manner.

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:
• Review emails received from UHC Network Management to determine issue for UHC contracted providers related to UMR claims
• Manage email inventory to ensure emails are reviewed and resolved accurately and meet required turnaround time with proper communication back to the sender, following up regularly as needed
• Reach out to appropriate UMR departments to assist in review and resolution of UHC Provider issues
• Ensure UMR plan benefits and processing is completely accurate on submitted claim review requests
• Work with UHC Network Management to obtain UHC contract language in regard to Prompt Pay, Medical Necessity, reconsideration requests, overpayments and special processing instructions Request medical records from providers when claim reach outs have been exhausted
• Review Social Media email submissions for urgent outreach and resolution with the member or the UMR group, including UHSS
• Educate UHC Network Management and UHC Providers in regard to UMR plan benefits and processes
• Call providers as needed for additional information or to assist on a complex claim review and explanation
• Assist with UHC projects and other tasks related to provider relations
• Prioritize and organize own work to meet agreed upon deadlines
• Work with both internal and external customers to identify and resolve complex problems

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:
• High School Diploma/GED (or higher) OR 2+ years of experience with UMR CPS medical claim processing and workflows
• 1+ years of experience with UMR CPS medical claim processing and workflows
• Intermediate proficiency withMicrosoft Excel (sort, filter, and entry)
• Intermediate proficiency with Microsoft Word (work within templates; create, develop, and send correspondence)
• Ability to read directions and apply mathematical calculations

Soft Skills:
• Strong research and analytical skills
• Excellent interpersonal skills at both an individual and team level
• Excellent written, verbal and business communication skills
• Ability to operate in a fast paced, goal-oriented production environment
• Ability to independently work on projects, reports, and assignments
• All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

For more information on our Internal Job Posting Policy,click here.

California, Colorado, Nevada,Connecticut,New York, New Jersey,Rhode Island orWashington Residents Only:The hourly range forCalifornia, Colorado, Nevada,Connecticut,New York, New Jersey,Rhode Island orWashingtonresidents is $18.80 to $36.78 per hour.Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

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.

#RPO, #green
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