[Hiring] Senior Recovery Resolution Representative @UnitedHealth Group

Role Description

This position is National Remote. You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

As part of the Recovery and Resolutions team, you will:

• Identify, investigate, and resolve claim payment inaccuracies while ensuring compliance with applicable policies and regulations.
• Provide claims expertise by reviewing, researching, investigating, and resolving healthcare claims and recovery opportunities for health plans, commercial customers, and government entities.
• Analyze claim outcomes, identify trends, and communicate findings to support process improvement opportunities.
• Ensure adherence to state and federal compliance policies, reimbursement policies, and contract compliance.
• Meet productivity, quality, and compliance standards while managing assigned inventory.
• Utilize multiple internal systems and applications to research claim history, validate findings, and document resolution activities.

This role requires strong analytical skills, attention to detail, and the ability to navigate multiple systems to support recovery and resolution efforts. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Qualifications

• High School Diploma / GED OR equivalent work experience
• Must be 18 years of age OR older
• 2+ years of experience researching, processing, auditing, or resolving healthcare claims
• Experience interpreting claim details, payment history, contractual language, and benefit information
• Ability to navigate multiple systems and applications to conduct claim research and analysis
• Ability to work full-time, Monday through Friday, with flexibility during normal business hours of 8:00 AM to 5:00 PM and occasional overtime as needed

Requirements

• Experience using EDSS, Doc360, PICTS, CAP, or similar claim research and workflow management applications
• Experience using healthcare claims processing and research platforms such as FACETS, COSMOS, UNET, NICE, or similar systems
• Ability to navigate multiple systems, interpret claim history, conduct research across various platforms, and quickly learn new applications

Telecommuting Requirements

• Ability to keep all company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

Soft Skills

• Strong analytical and critical thinking skills
• Excellent written and verbal communication skills
• Ability to prioritize workload and manage competing priorities
• Demonstrated attention to detail and accuracy
• Ability to work independently and collaboratively in a fast-paced environment
• Ability to make sound decisions based on claim details, policies, and supporting documentation

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution (all benefits are subject to eligibility requirements)

Pay

The hourly pay for this role will range from $20 - $36 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc.

Application Deadline

This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.