Recovery Resolutions Analyst - Omaha, NE

UnitedHealth Group Incorporated

Position Description:

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.

Primary Responsibilities:

• Investigate, recover, and resolve all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities
• Initiate phone calls to members, providers, and other insurance companies to gather coordination of benefits
• 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
• Perform other duties as assigned
• Conducts data entry and re-work; analyzes and identifies trends and provides reports as necessary.
• Initiating telephone calls to members, providers and other insurance companies to gather coordination of benefits data.
• Investigating and pursuing recoveries and payables on subrogation claims and file management.
• Processing recovery on claims.
• Ensuring adherence to state and federal compliance policies, reimbursement policies and contract compliance.
• Conducting contestable investigations to review medical history.
• Monitoring large claims including transplant cases.
• Analyzes and investigates.
• Provides explanations and interpretations within area of expertise.

Requirements:

• High school diploma or GED
• Intermediate MS Word and Excel skills

Assets:

• 2+ years of Claims Adjustment Experience
• Bachelor’s degree
• Experience in the Healthcare industry in an office environment
• FACETS experience
• Advanced Excel Skills
• Intermediate PowerPoint, Access skills
  

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 UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 17 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.

Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.


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