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Conditional Payment Verification Specialist - Tampa, FL

UnitedHealth Group

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Job Details

Conditional Payment Verification Specialist - Tampa, FL(Job Number:732539)

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.(sm)

Primary Responsibilities:
  • Responsible for all conditional payment reporting and procurement of conditional payment letters from Medicare, Medicare Advantage Plans and Medicaid for workers’ compensation, auto and liability cases.
  • Serve as the liaison between Optum Settlement Solutions and BCRC / CRC / CMS / MAPs / Medicaid.
  • Performs follow up for final settlement documents and distributes to the lead contractor once received.
  • Works directly with legal staff for final demands or appeals process.
  • Processes all mail related to conditional payment letters received
  • Manages the required paperwork such as Letters of Authorization, Proof of Representation and Consent to Release forms
  • Work directly in the Medicare Secondary Payer Recovery portal (internet - based) and Optum’s Medicare Connect portal
  • Distributes the status responses that the BCRC / CRC generates.
  • Provides status updates to client regarding conditional payment issues.
  • Responsible for handling all phone calls, emails and faxes on assigned cases.
  • Participates on client conference calls and trains new associates within the conditional payment team, as needed.
  • Works with Management on special projects as necessary.
  • Performs other job functions as assigned by management.

Job Claim Operations
Primary Location US-Florida
Other Location US-FL-Tampa
Organization OptumRx Workers Comp
Schedule Full-time
Number of Openings 1
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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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