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Healthcare Recovery Investigator - Eden Prairie, MN or Wauwatosa, WI

UnitedHealth Group

Eden Prairie, MN
Job Code:
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Job Details

735503 Healthcare Recovery Investigator Eden Prairie MN or Wauwatosa WI

Healthcare Recovery Investigator - Eden Prairie, MN or Wauwatosa, WI (735503)

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 17 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 & Performance.

As a Healthcare Recovery Investigator, you will be responsible for completing investigations to determine subrogation potential. Using your investigative / analytical skills you will work with a variety of contacts to gather accident details. You will use this information in conjunction with state and federal compliance policies, reimbursement policies and contract compliance to complete your investigation and prepare the subrogation file to be handled by our Analyst team. You must be able to work in a fast paced environment, multi - task and handle changing priorities.

Primary Responsibilities:
  • Handle a steady volume of new referrals daily.
  • Understands concepts of coverage, policy interpretation and liability determination to analyze and move claims towards resolutions.
  • Research applicability of laws, regulations and other requirements to cases.
  • Ensure compliance with Health Insurance Portability and Accountability Act.
  • Validate claim liability, adjuster's contact information, claim status, availability of coverage and accident - related injuries.
  • Focus will be on speed and quality of contacts, investigations and evaluations.
  • Researching and analyzing information gathered through investigation.
  • Thoroughly document all written and verbal communications.
  • Ability to maintain professionalism and confidentiality.
  • Assist with training and mentoring for other Subrogation staff as needed.
  • Other tasks or projects as needed to support the Subrogation Team.
Required Qualifications:
  • High School Diploma / GED or higher
  • Previous experience typing on a keyboard
  • Ability to work an 8 - hour shift with a flexible start time between 7:00 am - 9:00 am Monday through Friday and occasional mandatory overtime
Preferred Qualifications:
  • Associate's Degree (or higher) in Paralegal Studies or in a Business - related area
  • Understanding of subrogation principles, health insurance and / or P&C insurance
  • Knowledge of local, state and federal laws and regulations pertaining to insurance
  • Ability to create and edit letters with Microsoft Word
  • Ability to create and modify spreadsheets Microsoft Excel
Soft Skills:
  • Previous experience meeting monthly and annual production expectations, quality metrics, and turn - around - time expectations
  • Ability to communicate professionally via email and phone
  • Ability to navigate within multiple internet browsers and computer monitors
  • Ability to deescalate calls
Physical Requirements and Work Environment:
  • Extended periods of sitting at a computer and use of hands / fingers across keyboard or mouse
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: claims, medical claims, healthcare claims, claims processing, claims processor; office, UnitedHealth Group, UnitedHealthcare, training class, customer service representative, customer service, CSR, Data Entry, adjustments, phone support

Job Details

  • Contest Number735503
  • Job TitleHealthcare Recovery Investigator - Eden Prairie, MN or Wauwatosa, WI
  • Job FamilyClaims
  • Business SegmentOptum Operations

Job Location Information

  • Eden Prairie, MN
    United States
    North America
  • Other LocationsWauwatosa, WI

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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