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Claims Auditor Consultant - Eden Prairie, MN US Telecommute

UnitedHealth Group

Eden Prairie, MN
Job Code:
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Job Details

Claims Auditor Consultant - Eden Prairie, MN US Telecommute(Job Number:701206)

Position Description:

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.

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)

This is a quality role that supports the Optum Payment Integrity Fraud, Waste, Abuse and Error business units. This role is responsible for the determining the accuracy of the outcome of claim payment decisions after clinical review of medical record submissions.

Primary Responsibilities:
  • Validate the accuracy of clinical medical record reviews and payment decisions.
  • Develop and deliver fact based audit determinations.
  • Serve on applicable cross-functional quality committees and work groups to identify and communicate common quality issues, trends, and patterns.

Job Claim Quality
Primary Location US-MN-Eden Prairie
Other Location US-MN-Minneapolis, US-FL-Tampa, US-TX-Dallas, US-WI-Wauwatosa, US-CT-Hartford, US-AZ-Phoenix, US-WI-Eau Claire
Organization Optum Ops-Claims
Schedule Full-time
Number of Openings 1
Apply on the Company Site

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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