Senior Recovery & Resolution Analyst - National Remote

You’ll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.The Senior Recovery & Resolution Analyst is accountable for the day - to - day revenue generation activities for the 1 - 2 clients that are assigned under his / her responsibility. This position will also support CDM client communications as needed for subject matter expertise.This position is full-time. Employees are required to work our normal business hours of 8:00 AM - 5:00 PM including flexibility.We offer 4 weeks of paid training. The hours of training will be based on your schedule during normal business hours or will be discussed on your first day of employment.All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.Primary Responsibilities:

Revenue Generation

Review and validate suspected claim overpayments of high complexity identified by various concept and selection criteria

Monitor monthly recovery submissions by assigned client(s) or area of expertise to ensure Data Mining team is able to meet monthly goals

Talent Development | Personal and Team

Develops a high level of knowledge on industry trends, policy changes, and plan - specific rules / nuances and reimbursement methodologies

Openly shares knowledge and experience

Mentors and develops team members

Integrates and applies others’ experience and ideas

Innovation

Responsible for learning, applying and maintaining cross - pollinated concepts, techniques, and methodologies

Participates in research and development of new concepts / trends

Provides opportunities for process improvement and participates in their implementation

Effectively and efficiently applies knowledge of customer - specific policies, contracts, and systems to develop concepts and document justification / rationale

Participates in developing and implementing new and enhanced user tools and techniques that deliver new insights, and increase the efficiency and effectiveness of overpayment identification and recovery processes

Product Leadership

Ensures work product is completed per contract or service level agreement as assigned

Participates in and contributes to internal meetings and communications when requested and/or necessary

Accountable for specific client appeals and rebuttals

Quality Assurance

Ensures Optum quality standards of product and processes

Ensures quality standards of concepts, policies and procedures

Ensures quality standards of all team members

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

4+ years of healthcare experience in the areas of payment integrity and / OR healthcare coding OR billing / reimbursement

4+ years of experience with auditing healthcare claims and / OR healthcare claims processing

Working knowledge of medical and claims payment policies

Intermediate proficiency in Microsoft Office Suite, including Microsoft Word, Microsoft Excel, and Microsoft Outlook

Ability to work any shift between the hours of 8:00 AM - 5:00 PM including flexibility

Must be 18 years of age OR older

Preferred Qualifications:

Experience in working with Medicare, Medicaid, and Commercial claims

Experience with Microsoft SQL

Experience with provider contracting

Telecommuting Requirements:

Ability to keep all company sensitive documents secure (if applicable

Required to have a dedicated work area established that is separated from other living areas and provides information privacy

Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

Soft Skills:

Demonstrates proficient verbal and written communication skills

Demonstrates ability to work efficiently and effectively with moderate direct supervision

Exhibits high standards of quality and attention to detail

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Washington, or Rhode Island Residents Only: The hourly range for California / Colorado / Connecticut / Hawaii / Nevada / New York / New Jersey / Washington / Rhode Island residents is $28.03 - $54.95 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