Senior Recovery/Resolution Representative - Eden Prairie, MN (386369)
Location: Eden Prairie, Minnesota
Description: UnitedHealth Group is at the momment seeking for Senior Recovery/Resolution Representative - Eden Prairie, MN (386369) right now, this position will be reside in Minnesota. More complete informations about this position opportunity please read the description below. Position Description:
Flexible? Friendly? Fast on your feet? That's a great start. Accurate? Accountable? Self Directed? These traits can take you places. Our claims operations are the focal point of handling information about services patients receive and they 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.
Primary Responsibilities:
Provide expertise claims support by reviewing, researching, investigating, negotiating and resolving all types of claims as well as recovery and resolution for health plans, commercial customers and government entities.
Analyze and identify trends and provides reports as necessary
Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance
Positions in this function are responsible for investigating and pursuing recoveries on subrogation claims. May include initiating telephone calls to attorneys, insurance companies, members and providers to gather relevant data. Independently manage the subrogation files and negotiate settlements within authority level to maximize dollars recovered and achieve customers' financial expectations. Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance.
Manage subrogation files; review, analyze and document a plan of action for subrogation recovery
Investigate accidents, identify sources of recovery, assert subrogation liens
Identify, monitor and evaluate claim data to determine third party liability and reimbursement amounts; ongoing analysis of claim activity to determine when treatment ceases
Review daily activity checklist (diary system) to monitor status of subrogation case, update lien amounts and determine priorities for case handling
Must use the phone extensively to contact various parties throughout the subrogation recovery process. The analyst will correspond with plaintiff's attorney, defense counsel, third party insurers, and all other parties of interest
Must be able to act independent of an attorney, present the client's case and negotiate a settlement with an adverse party with professionalism, integrity and vigor
Maintain working knowledge of basic ERISA and state subrogation laws.
Conduct legal research to ensure subrogation files are managed in accordance with laws and regulations
Assist with training and mentoring for other Subrogation staff as needed
Other tasks or projects as needed to support the Subrogation Team
Qualifications
Requirements:
High School Diploma or GED
1+ year with Microsoft Word, Excel and Outlook
1+ year of experience in at least one of the following categories: workers compensation, insurance, legal, subrogation, or collections
1+ year of Negotiation experience
1+ year experience with effective writing in a corporate setting of professional correspondence, emails, etc.
Assets:
Microsoft PowerPoint and Access experience is a plus
Experience working with sensitive Protected Health Information preferred
Typing minimum 35+ WPM preferred
OptumInsight
is part of the family of companies that make
UnitedHealth Group
one of the leaders across most major segments of the US health care system.
OptumInsight is one of the largest and fastest growing health information companies. We specialize in improving the performance of the health system by providing analytics, technology and consulting services that enable better decisions and results. We integrate workflow solutions that deliver data in real-time, and create actionable insights - processing health information that relates directly to and affects one in four patients in the U.S, one in every three Medicaid dollars and one in every five emergency room visits. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.
What can YOU do with the right information? At OptumInsight, the possibilities and the impact are limitless. No matter what your role is at OptumInsight, you'll be empowered to ask more questions, develop better solutions and help make the health care system greater than ever. It's always fresh. It's always exciting. And it's never been more important.
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
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If you were eligible to this position, please deliver us your resume, with salary requirements and a resume to UnitedHealth Group.
Interested on this position, just click on the Apply button, you will be redirected to the official website
This position will be opened on: Wed, 04 Jul 2012 20:36:02 GMT
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