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

The Provider Reimbursement Representative is responsible for activities associated with developing programs, policies, and strategies to ensure that contracted rates and reimbursement policies are applied accurately. The Provider Reimbursement Representatives support those who analyze claims, pre and post payment, to ensure contracts and reimbursement policies and procedures are priced accurately and assist company with initial deployment and ongoing support of systems and processes to leverage national network rates and policies. Other responsibilities may include involvement with fee schedule and contract template maintenance.

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

Primary Responsibilities:

• Capable of maintaining production set by the department and meeting established turnaround times
• Plan, prioritize, organize, and complete work to meet established objectives
• Transfer data from multiple systems into a single system
• Verify data by comparing it to source documents
• Knowledgeable with Repricing systems and develop basic skills in the Repricing area
• Must be able to key a minimum of 17 claims per hour and 136 claims per day
• Ability to act as a technical resource to others in assessing contracts and applying appropriate rates
• Comfortable learning new technology
• Excellent organizational skills
• Good time – management skills
• Detail oriented
• Strong research and analytical skills
• Excellent written and verbal communication skills

General Expectations:

• Apply knowledge/skills to a range of complex activities
• Demonstrate depth of knowledge/skills in assessing contracts and applying appropriate rates
• Solve complex problems on own
• Collaborate with team to solve complex problems
• Independently manage time and tasks
• Coordinate work of other team members when necessary

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) OR 4+ years of experience in data entry
• 2+ years of experience in data entry
• 2+ years of experience in the health industry
• 1+ year of experience with CPT, HCPCS, Revenue codes
• Intermediate level of proficiency with Microsoft Excel (sort & filter data) and Microsoft Word (create & edit documents)
• Ability to start shift between 6:30 am – 8:00 am, working 8 hours per day, 40 hours per week, Monday through Friday
• Ability to travel into the office at 1311 W. President George Bush Hwy, Richardson, TX 75080 as needed for training purposes

Preferred Qualifications:

• Ability to communicate effectively with external parties, both verbal and written
• Ability to document issues and recommend solutions effectively, both verbal and written
• Experience with repricing and NDB

Soft Skills:

• Strong Interpersonal skills: ability or desire to learn how to run small group meetings
• Strong business, written and oral communication skills
• Ability to handle a fast-paced environment with pressure based on project deadlines

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.

California, Colorado, Connecticut, Nevada, New York, Washington or Rhode Island Residents Only: The hourly range for California, Colorado, Connecticut, Nevada, Washington or New York City residents is $18.80 to $36.78. 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.

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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