• Job Description

  Req#: 2197950

  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

  In Provider Pick, the Provider Data Specialist or Data Loading Analysts (DLA) is a challenging one. One must have the ability to thoroughly review, analyze, and research complex health care claims to ensure claims are paid timely and accurately. Additionally, DLAs are responsible for various loading activities related to the provider network database (NDB). DLAs make informed decisions to deliver quality results and are responsible for properly maintaining the provider data housed in our core systems to allow for proper claim payment.

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

  Primary Responsibilities:

  • Assist in the processing of claims by applying a valid provider ID to claims on appropriate claims platforms
  • Apply business strategies, rules, and procedures as appropriate (e.g., determine correct system updates and correct provider ID to apply to claim)
  • Resolve provider database issues such as addresses, user warnings, demographic errors, etc. and make corrections as needed
  • Load and maintain non-par provider records in NDB to ensure accurate claims processing
  • Receive data from multiple inbound sources (e.g., spreadsheets, email, EWD, NDM, etc.)
  • Utilize database systems and tools to enter and/or research provider data (e.g., NDB; CSP FACETS, COSMOS, etc)
  • Contact providers to verify/clarify data and gather W9 and licensing information as needed
  • Consistently meet target production, quality, and time utilization metrics
  • Take responsibility by completing assignments in a timely and accurate manner
  • Communicate effectively with business partners to resolve claims and provider data discrepancies
  • Handle any escalated issues as directed by leadership
  • Maintain current knowledge of business strategies, rules, and procedures (e.g., attend training)
  • Participate in assigned ad hoc projects

  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)
  • 1+ years data entry experience
  • 1+ years customer service experience
  • 1+ years of computer experience utilizing Microsoft Office and computer navigation skills

  Preferred Qualifications:

  • 1+ years of experience in the healthcare industry
  • 6 months+ NDB loading experience
  • CSP Facets, COSMOS, UNET or other claims processing system experience
  • Knowledge of medical terminology and managed health care
  • Experience in a medical office setting or a corporate environment
  • Experience with medical claims
  • Experience working in an environment that included having accountability for meeting metrics
  • Demonstrated communication and organizational skills
  • Adept at utilizing dual monitors to compare data stored within multiple systems

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

  California, Colorado, Nevada, Connecticut, New York, New Jersey, Rhode Island or Washington Residents Only: The hourly range for California, Colorado, Nevada, Connecticut, New York, New Jersey, Rhode Island or Washington 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.

  Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

  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.

  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.

  #RPO #Green

• About the company

  UnitedHealth Group Incorporated is an American multinational managed healthcare and insurance company based in Minnetonka, Minnesota.

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