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Senior Claims Business Process Analyst - Las Vegas, NV

UnitedHealth Group


Location:
Las Vegas, NV
Date:
11/21/2017
2017-11-212017-12-20
Job Code:
736281
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Job Details

736281 Senior Claims Business Process Analyst Las Vegas NV

Senior Claims Business Process Analyst - Las Vegas, NV (736281)

Position Description

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.

Flexible, Friendly, Fast on your feet, that's a great start. Accurate, Accountable, Self Directed, These traits can take you places. Our claims operations are the focal point of handling information about services patients receive and they way those services get paid. It's complex, detailed work. It's fast paced challenge. It's a job that calls on you to be thoughtful, resourceful, team - driven and customer - focused. To put it mildly, there is never a dull moment. Senior Claims Business Process Analysts are responsible for all related aspects of claim system processes and claim business rules. Include claims systems utilization, capacity analyses / planning and reporting, claims-related business and systems analysis. Ensure data integrity, data security and process optimization.

Positions in this function are responsible for all related aspects of claim system processes and claim business rules. Includes claims systems utilization, capacity analyses / planning and reporting. Includes claims-related business and systems analysis. Ensures data integrity, data security and process optimization.

Primary Responsibilities:


  • Responsible for providing research and root cause analysis for claim quality remediation
  • Perform capacity planning and reporting
  • Responsible for all aspects of quality assurance
  • Create and edit requirements, specifications, cost benefit analysis and recommendations to proposed solutions
  • Facilitate development of process documentation
  • Follow standard programming guidelines and requirements as set by team
  • Standard documentation and tracking processes
  • Uses pertinent data and facts to identify and solve a range of problems within area of expertise
  • Knowledge of the Medicare business is desired for this position. The candidate should be familiar with Performance Guarantees and working to exceed the turnaround time and quality goals as well as an understanding on auto adjudication and working to increase this.
  • Analyzes and investigates.
  • Provides explanations and interpretations within area of expertise.

Requirements:


  • High School Diploma / GED or higher 
  • 1+ years of experience analyzing and solving customer problems in an office setting environment 
  • 2+ years in a technical or metrics in a claimsbased environment
  • Ability to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each product
  • Moderate proficiency with computer and Windows PC applications, which includes the ability to learn new complex computer system applications

Assets:


  • Undergraduates degree or higher preferred
  • 2+ years of Cosmos claim experience preferred

Take the next step, online at: www.yourlifesbestwork.com

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: 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: medical claims, healthcare claims, claims processing, claims processor; UnitedHealth Group, Optum

Job Details

  • Contest Number736281
  • Job TitleSenior Claims Business Process Analyst - Las Vegas, NV
  • Job FamilyClaims
  • Business SegmentOptum Operations

Job Location Information

  • Las Vegas, NV
    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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