UHN Adjustment and Call Representative

Company: UnitedHealth Group
Location: Wausau
Posted on: September 20, 2023

Job Description:

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing -your life's best work.SM
You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. -
The -Provider Reimbursement Coordinator -(also known as -UHN Adjustment and Call Representative) is responsible for answering Incoming calls from Providers while ensuring a high level of Customer Service and maximizing productivity on claim adjustments.
Primary Responsibilities:

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• Provide the very best Customer Service to callers (medical providers) - - -
  
• Resolve, educate and respond to medical provider inquiries in regards to network pricing or participation issues
  
• Adjust medical claims according to specified procedures and standards, meeting all production and quality standards
  
• Initiate and complete the dispute resolution intake form
  
• Review and complete adjustment project details for previously processed claims in regards to network discounts and claim edits
  
• Prioritize and organize own work to meet agreed upon deadlines
  
  What are the reasons to consider working for UnitedHealth Group? - - Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. -Some of our offerings include:
  
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  • Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
    
  • Medical Plan options along with participation in a Health Spending Account or a Health Saving account
    
  • Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
    
  • 401(k) Savings Plan, Employee Stock Purchase Plan
    
  • Education Reimbursement
    
  • Employee Discounts
    
  • Employee Assistance Program
    
  • Employee Referral Bonus Program
    
  • Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
    
  • More information can be downloaded at: -
    
    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:
    
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    • High School Diploma/GED (or higher) OR 3+ years of Healthcare Customer Service experience
      
    • 1+ year of Healthcare Customer Service experience
      
    • Intermediate level of proficiency -with processing adjustments using UMR CPS (Claims Processing System)
      
    • Intermediate level of proficiency with Microsoft Excel to create, update and sort spreadsheets
      
    • Ability to successfully navigate computer systems and software
      
    • Ability to read and interpret directions and apply mathematical calculations to claim adjustments
      
      Preferred Qualifications:
      
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      • 1+ year of experience taking incoming calls with VCC (virtual call center)
        
      • Previous UHC network exposure or experience
        
        Soft skills:
        
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        • Strong interpersonal skills at both an individual and team level
          
        • Strong written, verbal and business communication skills
          
        • Strong research and analytical skills
          
          Careers with UnitedHealthcare. Work with a Fortune 5 organization that's serving millions of people as we transform health care with bold ideas. Bring your energy for driving change for the better. Help us improve health access and outcomes for everyone, as we work to advance health equity, connecting people with the care they need to feel their best. As an industry leader, our commitment to improving lives is second to none.
          *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. -
          
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          California, Colorado, Nevada, -Connecticut, New Jersey, -Rhode Island, Washington or New York, NY Residents Only: -The hourly range for -California, Colorado, Nevada, -Connecticut, -New Jersey, Rhode Island, Washington or New York, NY residents is $16.00 to $31.44 per hour. -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. -
          
          
          
          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.
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          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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          #RPO, #Yellow

Keywords: UnitedHealth Group, Appleton , UHN Adjustment and Call Representative, Other , Wausau, Wisconsin