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Healthcare EDI Senior - Ontario, CA

UnitedHealth Group

Ontario, CA
Job Code:
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Job Details

749375 Healthcare EDI Senior Ontario CA

Healthcare EDI Senior - Ontario, CA (749375)

Position Description

Position Description:

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 6 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 and Performance.

This role will provide Healthcare EDI expertise and support by reviewing, researching, investigating EDI transactions. This role will analyze and identify trends and provide reports as necessary for inbound and outbound EDI transactions. Consistently meet established productivity, schedule adherence, and quality standards. Facilitate as EDI Subject Matter Expert between internal / external customers to maintain positive working relationships with all trading partners, key health plan stakeholders, departments and / or the IPA.

Primary Responsibilities:
  • Coordinate meetings with Clearinghouse representative, Health Plans, and Medical Groups and / or provider networks, to resolve potential missing encounter data
  • Ability to independently implement moderate to complex electronic data transactions (ANSI X12 837, 835, 277CA and 999)
  • Assist with coordinating the implementation of new EDI trading partners
  • Monitor routine reporting between Clearinghouses, Health Plans and / or Provider networks to maintain regulatory compliance with EDI transmission reconciliation
  • Analyze and resolve encounter data discrepancies resulting from EDI transaction errors
  • Accountable for identifying root cause issues thereby mitigating repeated occurrences
  • Regularly exercises critical thinking to determine best method for accomplishing work and achieving objectives.
  • Maintain frequent and effective communication standards with internal and external customers.
  • Performs any other assigned duties as required by company and / or department
Required Qualifications:
  • High School Diploma / GED
  • Proficiency with MS Office products (Microsoft Word, Microsoft Excel, and Microsoft Outlook) with the ability to create, edit, save and send documents / spreadsheets
  • 2+ years of experience analyzing and solving customer problems in an office setting environment
  • Must have familiarity of operational EDI transactions with one or more of the Healthcare X12 transaction sets (820, 834, 835, 837P, 837I, 270 / 271, 276 / 277, 277CA, 997 or 999)
  • Moderate proficiency with a computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
Preferred Qualifications:
  • Some College (or higher)
Soft Skills:
  • Ability to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each product
  • Ability to work independently given minimal direction
  • Proven ability to take responsibility and be accountable
  • Should be Innovative, adaptable and flexible
  • Previous experience or knowledge of claim operations.
  • Ability to identify issues and resolve them cooperatively
  • Requires excellent communication skills, both written and verbal
  • Able to represent the company in a professional and positive manner
  • Excellent investigational skills
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.
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.
Keywords: UHG, Optum, EDI, healthcare, transactions, research, analyze, claims, reconciliation, customer service, office, administrative, investigation

Job Details

  • Contest Number749375
  • Job TitleHealthcare EDI Senior - Ontario, CA
  • Job FamilyClaims
  • Business SegmentOptum Operations

Job Location Information

  • Ontario, CA
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelIndividual Contributor
  • ShiftDay Job
  • TravelNo
  • Telecommuter PositionNo
  • Overtime StatusNon-exempt

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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