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Senior Recovery Resolutions Analyst - South Portland, ME

UnitedHealth Group

South Portland, ME
Job Code:
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Job Details

Senior Recovery Resolutions Analyst - South Portland, ME(Job Number:725709)

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.

Optum is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.

If you get excited about the life transforming potential of bringing health care information to the right place, at the right time, to support crucial decisions, welcome to Optum.

We're one of the largest and fastest growing health information companies and the only organization in our industry with the information, technology and consulting expertise to solve the most significant challenges in health and human services.

As a vital member of the UnitedHealth Group family, we serve customers in every segment of the health care field. This includes government agencies, pharmaceutical companies, hospitals and health delivery networks, insurance providers and, of course, the diverse business divisions of UnitedHealth Group.

Bring your talent to an industry leader with the information, technology, and consulting expertise to help transform health and human services. No matter what your role, you'll be empowered to ask more questions, develop better solutions and help make the health care system greater than ever.

Positions in this function are responsible for investigating, recovering and resolving all types of claims as well as recovery and resolution for health plans, commercial customers and government entities. Position will include providing support for incoming provider calls and initiating telephone calls to providers to gather medical claims documentation. Investigate, pursue and process recovery on claims. Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance. May conduct contestable investigations to review medical history.

Primary Responsibilities:
  • Handle incoming / outgoing calls, faxes and mail from healthcare providers
  • Monitor and manage call and review case load, ensuring expedient review resolution
  • Compile documentation and review for accuracy and completeness
  • Data entry for all calls, documentation, and review outcomes
  • Participate in all meetings and training sessions
  • Manages assigned projects
  • Attend onsite reviews
  • Attend and / or participates in hearings
  • Actively identifies and shares best practices
  • Review provider disputes, summarize specifics of review results

Job Claim Recovery/Resol/COB/Subro
Primary Location US-ME-South Portland
Other Location 
Organization Optum Ops-Payment Integrity
Schedule Full-time
Number of Openings 1
Apply on the Company Site

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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