Claims Business Process Analyst - Remote in TX

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Opportunities at WellMed , part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you discover the meaning behind Caring. Connecting. Growing together.

Our claims operations, including our Claims Business Process Analysts , 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.

This position is full-time, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm must work CST time zone . It may be necessary, given the business need, to work occasional overtime.

We offer weeks of on-the-job training. The hours of the training will be 8:00 am - 5:00 pm CST from Monday - Friday

If you are located in TX, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities

• Research CES (Claims Editing System) provider disputes and collaborate with CES rule writer to make any applicable updates to CES edit rationale
• Root cause analysis and error correction for encounter error rejections
• Provide expertise claims support for all related aspects of claim system processes and claim business rule
• Ensure data integrity, data security and process optimization by identifying trends and provide reports as necessary
• Create and edit requirements, specifications, cost benefit analysis and recommendations to proposed solutions
• Facilitate development of process documentation
• Use pertinent data and facts to identify and solve a range of problems within area of expertise
• Investigate non-standard requests and problems, with some assistance from others
• Assume responsibility for successfully accomplishing work objectives and delivering business results; setting high standards of performance for self and others
  
  

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
• Must be 18 years of age OR older
• 1 years of experience with a claims processing
• Provider claims dispute experience
• Intermediate proficiency with Microsoft Word and Microsoft Excel
• Ability to work between the hours of 8:00 am - 5:00 pm CST from Monday - Friday including the flexibility to work occasional overtime based on business need
  
  

Preferred Qualifications

• Managed Care experience (Medicare)
• Frequency 7 experience
• Proficiency with Microsoft Access, Microsoft Visio, and Microsoft PowerPoint
• Ability to manage multiple projects
• IKA systems
  
  

Telecommuting Requirements

• Reside within TX
• Ability to keep all company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
• All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy  
  
  

The hourly range for this role is $19.86 to $38.85 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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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