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Senior Claims Quality Analyst - Irvine, CA or Schaumburg, IL

UnitedHealth Group

Irvine, CA
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Job Details

736632 Senior Claims Quality Analyst Irvine CA or Schaumburg IL

Senior Claims Quality Analyst - Irvine, CA or Schaumburg, IL (736632)

Position Description

Position Description:

The health care system is still evolving at a rapid pace. Technology is driving new advances in how patient care is delivered and how it’s reimbursed. Now, UnitedHealth Group invites you to help us build a more accurate and precise approach to claims adjudication. In this role, you’ll be responsible for all aspects of quality assurance within the claims job family. That includes assisting, educating, problem-solving and resolving challenging situations to the best possible

This is a challenging role with serious impact. You’ll be providing a senior level of support and subject matter expertise within a fast paced, intense and high volume claims operation where accuracy and quality are essential outcomes. Join us and build your career with the industry leader.

Primary Responsibilities:
  • Review, research, investigate and audit claims and provide feedback to team members on audit results
  • Analyze and identify trends and provide feedback and reports to reduce errors and improve claims processes and performance
  • Analyze and use information to build recommendations to reduce errors and improve process performance
  • Create, maintain and track reports in relation to performance

Required Qualification:

  • High School Diploma / GED or higher 
  • 2+ years of experience analyzing and solving customer problems in an office setting
  • 3+ years of working experience in claims processing or quality
  • 3+ years of experience utilizing claims platforms such as UNET, NICE, Pulse, COSMOS, FACETS, and / or Diamond
  • Intermediate level of MS Excel and PowerPoint

Preferred Qualifications:

  • Undergraduate Degree or higher
  • Project coordination / management experience regarding claims payment and healthcare projects
  • Process improvement experience
  • Previous PBM experience

OptumRx is an empowering place for people with the flexibility to help create change. Innovation is part of the job description. And passion for improving the lives of our customers is a motivating factor in everything we do.


If you're ready to talk about groundbreaking interactions, let's talk about what happens when a firm that touches millions of lives decides to gather results from millions of prescriptions every month and analyze their impact. Let's talk about smart, motivated teams. Let's talk about more effective and affordable healthcare solutions. This is caring. This is great chemistry. This is the way to make a difference. We're doing all this, and more, through a greater dedication to our shared values of integrity, compassion, relationships, innovation and performance.  Join us and start doing your life’s best work.SM

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.

Key words: Healthcare, health care, Managed Care, Claims, Customer Service, Claims Quality

Job Details

  • Contest Number736632
  • Job TitleSenior Claims Quality Analyst - Irvine, CA or Schaumburg, IL
  • Job FamilyClaims
  • Business SegmentOptumRx

Job Location Information

  • Irvine, CA
    United States
    North America
  • Other LocationsSchaumburg, IL

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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