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Senior Recovery / Resolutions Representative - Franklin, TN

UnitedHealth Group


Location:
Franklin, TN
Date:
02/20/2018
2018-02-202018-03-21
Job Code:
746455
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Job Details

746455 Senior Recovery Resolutions Representative Franklin TN

Senior Recovery / Resolutions Representative - Franklin, TN (746455)

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. As part of our Recovery and Resolutions team, you'll help understand and overcome errors in claims processing. You'll have all the tools and backing you need to help manage subrogation files, negotiate settlements and ensure adherence to compliance policies. All the while, you'll be building your career with a leader and reaching for the highest levels of performance as you do your life's best work.SM

This is a challenging role with serious impact. You'll need to sort through complex situations to understand and clarify where errors happened or where they may continue to happen. It's a fast paced environment that takes focus, intensity and resilience.

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. May include initiating telephone calls to members, providers and other insurance companies to gather coordination of benefits data. Investigate and pursue recoveries and payables on subrogation claims and file management. 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. May monitor large claims including transplant cases.

Required Qualifications:
  • High school diploma / GED or higher
  • 2+ years of health care experience; i.e. working in an insurance setting, in a provider’s office, billing office, doctor’s office, etc.
  • 2+ years of customer service experience; i.e. analyzing and solving customer problems
  • Intermediate level of experience with MS Excel using the sort and filter functions
  • 1+ years of experience in a collector role
  • Must be able to work 8 hour shift between the hours of 7:55am to 4:25pm, Monday-Friday
Preferred Qualifications:
  • Experience in medical claims and / or adjustments
  • Customer service experience in a health care and / or call center environment
  • Experience in medical insurance; i.e. dealing with insurance from a billing and/or health plan standpoint
Physical Requirements and Work Environment:
  • Frequent speaking, listening using a headset, sitting, use of hands/fingers across keyboard or mouse, handling other objects, long periods working at a computer
  • Service center environment with moderate noise level due to Representatives talking, computers, printers, and floor activity
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.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.


Keywords:  UnitedHealth Group; Senior Recovery/Resolutions Representative; Franklin, TN; health care; customer service; MS Excel; collections; medical claims; call center; medical insurance

Job Details

  • Contest Number746455
  • Job TitleSenior Recovery / Resolutions Representative - Franklin, TN
  • Job FamilyClaims
  • Business SegmentOptum Operations

Job Location Information

  • Franklin, TN
    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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