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Recovery / Resolutions Analyst - Franklin, TN

01/24/2018Call Center
Job Location:
Franklin, TN
Metro Area:
TN - Nashville
Company Name: UnitedHealth Group
Website:  Click to Visit
UnitedHealth Group
Position Description:Energize your career with one of Healthcares fastest growing companies. You dream of a great career with a great company where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, its a dream that definitely can come true. Already one of the worlds leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.This opportunity is with one of our most exciting business areas: Optum a growing part of our family of companies that make UnitedHealth Group a Fortune 6 leader.Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.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.The Recovery / Resolution Analyst handles information about patient services and how the services are paid by investigating and pursuing recoveries through contact with various parties. The representative manages subrogation files, negotiates settlements, and ensures adherence to compliance policies.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.Primary Responsibilities:Investigate, recover, and resolve all types of claims as well as recovery and resolution for health plans, commercial customers, and government entitiesInitiate phone calls to members, providers, and other insurance companies to gather coordination of benefitsInvestigate and pursue recoveries and payables on subrogation claims and file management.Process recovery on claimsEnsure adherence to state and federal compliance policies, reimbursement policies, and contract compliancePerform other duties as assignedWill discuss during discoveryAnalyzes and investigates.Provides explanations and interpretations within area of expertise.

Qualifications:

Required Qualifications:High school diploma / GED or higher 2+ years of health care experience; i.e. working in an insurance setting, in a providers office, billing office, call center, etc. 2+ years of customer service experience; i.e. analyzing and solving customer problemsIntermediate level of proficiency with MS Excel; i.e. creating spreadsheets, sorting, filtering, etc.1+ years of leadership experienceMust be able to work 8 hour shift between the hours of 7:55am to 4:25pm, Monday-FridayPreferred Qualifications:Experience in medical claims and/or adjustments Experience within a collector roleCustomer service experience in a healthcare and/or call center environmentMedical insurance backgroundPhysical 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 computerService center environment with moderate noise level due to Representatives talking, computers, printers, and floor activityCareers 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; Recovery - Resolutions Analyst; Franklin, TN; health care; customer service; MS Excel; leadership; medical calims; collections; call center; medical insurance
 
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