Senior Recovery Resolution Representative

Claims Recovery Specialist

Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

This position is full-time (40 hours / week), Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7 : 55 AM - 4 : 25 PM. It may be necessary, given business need, to work occasional overtime and / or weekends or holidays.

We offer 4 weeks of on-the-job training. The hours of training will be aligned with your schedule.

Primary Responsibilities :

• Take inbound calls from providers and / or make outbound calls to providers to discuss and resolve outstanding overpayments (95% of your day can be on phones)
• Provide claims expertise support by reviewing, researching, investigating, negotiating, and resolving all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities
• Fundamental Execution : Plan, prioritize, organize and complete work to meet established production goals, quotas and deadlines in a fast pace and ever-changing environment
• Communicate professionally with the provider to ensure PRS is meeting the needs and expectations of the client; build a good rapport with the provider contacts by establishing professional working relationships to ensure timely recoveries
• Escalate recovery efforts through many avenues to progress and resolve the situations
• Analyze, identify trends, and provide inventory and or client updates as necessary
• Meet state and federal compliance policies, reimbursement policies, and contract compliance
• Works independently while acting as a resource and mentor for others
• Perform other duties as assigned

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications :

Preferred Qualifications :

Soft Skills :

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.00 - $35.72 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.