Strategic Account Services Claim Adjustor (M&R Hospital) - National Remote

$1,500 Sign On Bonus For External Candidates

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

You’re looking for something bigger for your career. You’re looking for a place where you will be empowered to be your best. When you join UnitedHealthcare, you’ll be part of a team committed to reshaping the way health care works for millions. You’ll join us on a mission to not only deliver the best customer service in the health care industry, but the best customer service. Period. You won’t just provide customer service; you’ll change health care for the better starting with every health care provider you talk to. Your commitment to supporting them will directly translate into better care for their patients. And you’ll be well supported with the latest tools and advanced training classes to set you up for success. Don’t wait to join us! There’s never been a better time than now to start doing your life’s best work.^SM

As a Strategic Account Services Claim Adjustor, you’ll function with a higher level of empowerment and independence to resolve designated provider issues and respond to inquiries with efficiency, urgency and compassion. This role builds on your expertise to identify and exceed our customer expectations by committing to and building on-going strong relationships with our providers. You’ll do this every day by providing a high touch level of service as you respond to claim inquiries from health care providers to resolve their issues regarding health care claims and payments. At the end of each day, you’ll know that you provided an exceptional level of service and that your customers would agree.

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 6:00am - 6:00pm. It may be necessary, given the business need, to work occasional overtime.

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

Primary Responsibilities:

• Resolve issues without additional review or approval thereby reducing time and improving the overall provider satisfaction
• Perform a variety of complex, simple and closed / denied adjustments
• Communicates directly with the provider to analyze and identify the providers’ service issue (i.e. benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits-EOBs) 
• Utilizes all tools, resources, and systems available to drive towards resolution
• Proactively takes necessary steps to prevent further service issues of similar type
• Navigate through the appropriate computer system(s) to identify the current status of the issue and provide appropriate response to claim issue using all resources and escalation points available within the service model
• Focus on developing a strong relationship with the provider by providing contact information, dedicated facsimile number, follow-up work as needed and owning the resolution of the service issue
• Seek opportunities to reduce the administrative burden on the provider by advocating new tools or submission points
• Deliver all information and questions in a positive, conversational and compassionate manner to facilitate developing a relationship with the provider, while providing the best customer service experience possible
• Meet the performance goals established for the position
• Comply with all current policies, procedures and workflows

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)
• 2 years of Customer Service experience in a call center environment inclusive of the ability to deescalate complaints and communicate clearly with providers the outcome of reviews
• 2 years of claims experience
• Experience using Microsoft Word (creating and editing documents), Microsoft Excel (sorting, filtering, analyzing data), Microsoft Outlook (composing and sending email, managing calendars), and Microsoft OneNote (organizing data and training materials)
• Ability to work any of our 8-hour shift schedules during our normal business hours of 6:00am - 6:00pm. It may be necessary, given the business need, to work occasional overtime.

Soft Skills:

• Excellent communication skills including experience with customer service calls
• Ability to deescalate complaints and communicate clearly with providers the outcome of reviews
• Ability to multi-task and manage competing priorities

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 5 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.^SM

Colorado, Connecticut, Nevada or New York City Residents Only: The salary range for Colorado residents is $18.17 - $32.26. The salary range for Connecticut / Nevada / New York City residents is $20.00 - $35.53. 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

**PLEASE NOTE** The sign on bonus is only available to external candidates. Candidates who are currently working for a UnitedHealth Group, UnitedHealthcare or related entity in a full time, part time, or per diem basis ("Internal Candidates") are not eligible to receive a sign on bonus.

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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