POSITION DESCRIPTION

Everybody likes winning. Right? We sure do. And UnitedHealth Group has the right combination of leadership and innovation to ensure more wins in the marketplace everyday. As we take on new customers, we're driving new opportunities for people like you. More and more employers are turning to us for a higher level of quality and performance in health care services. Now, we invite you to help us welcome these new members as you help install assigned benefits accounts. You'll be responsible for overall employer contract loading using various databases and/or source documents. We provide the training, resources and opportunities you'd expect from a Fortune 6 leader.

PRIMARY RESPONSIBILITIES:

• Understand how various provider components in Facets fit together so claims pay correctly related to authorization and referrals
• Interpret provider contracts, fee schedules and rates in order to set up configuration correctly to ensure providers are paid according to the source of truth(s)
• Collaborate with stakeholders to gather, assess, interpret and document customer needs and requirements
• Identify and analyze issues to provide solutions to respond to internal and external customer needs
• Research claims issues to determine configuration gaps, update configuration as applicable
• Audit configuration against contract requirements to verify configuration following source documentation
• Work with minimal guidance and supervision
• Serve as a resource to other team members
• Consistently meet established productivity, schedule adherence, and quality standards while maintaining expected attendance
• Assist with capitation payments and reconciliations

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.

CAREERS WITH OPTUM. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do YOUR LIFE'S BEST WORK.(SM) © 2018 OptumCare. All Rights Reserved. OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare's support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians. Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment

REQUIRED QUALIFICATIONS:

• 2+ years' experience working with Medicare provider configuration
• 2+ years' health insurer experience handling provider billing/co-payments/co-insurance
• 2+ years of claims issue resolution or other areas of Facets configuration
• 2+ years' experience working with Facets database tables and configuration
• Proficiency in Microsoft Word, Excel, and Outlook.
• Computer proficiency including, but not limited to, ability to learn new computer system applications.

PREFERRED QUALIFICATIONS:

• 2+ years' health insurer experience resolving provider claim issues
• Experience with Medicare medical benefit plans
• Experience with COSMOS or UNET or NICE
• Experience building and running SQL queries using tools such as MS Access, Query Builder, or similar
• Knowledge of supporting tools from Trizetto and other vendors such as CMU or similar applications

A Fortune 6 company, we're focused on helping people live healthier lives while making the health system work better for everyone. Here, we seek to empower people with the information, guidance and tools to make personal health choices. We work harder and we aim higher. We expect more from ourselves and each other. And, at the end of the day, we’re doing a lot of good for more than 142 million people worldwide.