Senior Claims Business Process Consultant - Work from Home
Company: UnitedHealth Group
Location: Biloxi
Posted on: June 19, 2022
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Job Description:
If you are located within the state of Mississippi, you will
have the flexibility to telecommute* (work from home) as you take
on some tough challenges.
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.SM
Our claims operations, including our Senior Claims Business Process
Consultants, are the focal point of handling information about
services patients receive and the way those services get paid. It's
complex, detailed work. It's fast paced challenge. It's a job that
calls on you to be thoughtful, resourceful, team-driven, and
customer-focused. To put it mildly, there is never a dull
moment.
The Community & State Encounter Program Management team has
oversight of complete, timely and accurate encounter (claim)
submissions to state customers. This includes working with health
plans and states on process improvements, implementing new
requirements and analyzing current production results. A Medicaid
Encounter Senior Claims Business Process Consultant is a Subject
Matter Expert (SME) for one or more states, responsible for
establishing a thorough understanding of state encounter
requirements and meeting or exceeding those encounter requirements
and internal goals by correcting encounters with issues in order to
get them accepted by our state customers.
This position is full-time. Employees are required to work our
normal business hours of 8:00am - 5:00pm. It may be necessary,
given the business need, to work occasional overtime or
weekends.
Primary Responsibilities:
Perform end-to-end encounter business process activities, which
include:
Gathering and understanding state requirements and translating
these into business processes
Identifying opportunities to resolve encounter error root causes
using an understanding of upstream and downstream impacts
Participating in the creation, control, and improvement of business
processes
Produce monthly reporting of status against goals
Host or participate in regular meetings with health plans to share
encounter status and address issues
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.
Requirements Qualifications:
High School Diploma/GED (or higher)
2+ years of experience in data analysis
2+ years of experience in business and/or finance analysis
2+ years of experience working with and analyzing large quantities
of data
2+ years of experience with Microsoft Word (create, edit, save),
Microsoft Excel (pivot, formulas, VLOOKUP's, etc.), and Microsoft
Access (Queries, reporting, edit, etc.)
Preferred Qualifications:
Bachelor's Degree (or higher)
Healthcare-related background
Telecommuting Requirements:
Reside within the state of Mississippi
Required to have a dedicated work area established that is
separated from other living areas and provides information
privacy
Ability to keep all company sensitive documents secure (if
applicable)
Must live in a location that can receive a UnitedHealth Group
approved high-speed internet connection or leverage an existing
high-speed internet service
Soft Skills:
Experience in working multiple priorities
Experience in problem solving and researching conflicting and / or
inaccurate data
Experience in communicating analysis, including trends and
opportunities, to partners and customers in writing and
verbally
UnitedHealth Group requires all new hires and employees to report
their COVID-19 vaccination status.
Military & Veterans find your next mission: We know your background
and experience is different and we like that. UnitedHealth Group
values the skills, experience and dedication that serving in the
military demands. In fact, many of the values defined in the
service mirror what the UnitedHealth Group culture holds true:
Integrity, Compassion, Relationships, Innovation and Performance.
Whether you are looking to transition from active duty to a
civilian career, or are an experienced veteran or spouse, we want
to help guide your career journey. Learn more at
https://uhg.hr/transitioning-military
Learn how Teresa, a Senior Quality Analyst, works with military
veterans and ensures they receive the best benefits and experience
possible. https://uhg.hr/vet
Careers with UnitedHealthcare. Let's talk about opportunity. Start
with a Fortune 10 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 wherever 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
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.
Keywords: #RPO, #YELLOW
Keywords: UnitedHealth Group, Biloxi , Senior Claims Business Process Consultant - Work from Home, Professions , Biloxi, Mississippi
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