If you are located in within commuting distance to 2720 Tenaya, Las Vegas, NV, you will have the flexibility to work from home and the office in this hybrid role* as you take on some tough challenges.

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 provide consultative support to our business units and external vendor organizations. You’ll handle requests, define business requirements and coordinate resolutions incorporating State and Federal regulations. Join us and build your career with an industry leader.

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 (8:00am - 5:00pm). It may be necessary, given the business need, to work occasional overtime. Our office is located at 2720 Tenaya, Las Vegas NV.

Our office is located at within commuting distance to 2720 Tenaya, Las Vegas NV. Employees will be required to work some days onsite and some days from home

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  All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary Responsibilities:

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  Owns output at task level.
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  Work is generally limited to own function.
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  Sets priorities for the team to ensure task completion.
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  Coordinates work activities with other supervisors.
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  Develops plans to meet short-term objectives.
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  Identifies and resolves operational problems using defined processes, expertise and judgment.
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  Decisions are guided by policies, procedures and business plan.
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  Product, service or process decisions are most likely to impact individual employees and/or customers (internal or external).

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.

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.

Required Qualifications:

• High School Diploma / GED (or higher)
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  2+ years of supervisory experience or equivalent
  
• 2+ years of healthcare and/or claims experience
  
• Proficiency in Microsoft Word (create / edit docs), Microsoft Excel (data entry, sorting/filtering, creating/editing spreadsheets) and Microsoft Outlook (email / calendar)

Preferred Qualifications:

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  2+ years of experience using claims platforms such as Facets
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  2+ years of experience analyzing and solving problems
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  1+ years of experience in health care claims recovery, coordination of benefits and/or subrogation

Telecommuting Requirements:

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  Reside within commuting distance to 2720 Tenaya, Las Vegas NV
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  Required to have a dedicated work area established that is separated from other living areas and provides information privacy
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  Ability to keep all company sensitive documents secure (if applicable)
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  Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at https://uhg.hr/transitioning-military

Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible. https://uhg.hr/vet

Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of healthcare. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life’s best work.SM

Nevada Residents Only: The salary range for Nevada residents is $60,000 - $106,700. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives

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.

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