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Customer Support Specialist

Company: UnitedHealth Group
Location: Tonawanda
Posted on: January 5, 2020

Job Description:

You dream of a great career with a great company - where you can make an impact and help people.  We can offer you just this. And with the incredible growth of our business, it’s a dream that definitely can come true when you join us as a Claims Representative Associate . Already one of the world’s leading health care companies, UnitedHealth Group is relentlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives.  Whether you have prior experience or not, we’ll provide extensive training and a highly supportive environment for all of our Claims team members. This is your opportunity to make a difference, grow your career and do  your life’s best work. (SM) As a Claims Representativ e Associate you’ll be responsible for analyzing complex healthcare claims that require research to determine action steps and mathematical calculations necessary to produce accurate payment.  The claims position requires a high level of quality which is to be maintained while achieving a productivity goal.  You’ll put your skills and talents to work as you review, research, and process medical claims.  It’s complex, detailed work.  It’s a 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 (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 (6:00am to 6:00pm). It may be necessary, given the business need, to work occasional overtime or weekends. Our office is located at 500 Colvin Woods Parkway, Tonawanda, NY, 14150. To learn even more about this position, click here to watch a short video about the job:  http://uhg.hr/UHC-ClaimsRep There are several steps in our hiring process - it’s a thorough process because we want to ensure the best job and culture fit for you and for us. In today’s ultra-competitive job market, the importance of putting your best foot forward is more important than ever. And you can start by completing all required sections of your application. (i.e. profile, history, certifications and application/job questions). Once you submit your resume, you’ll receive an email with next steps. This may include a link for an on-line pre-screening test that we ask you to complete as part of our selection process.  You may also be asked to complete a digital video interview, but we will offer full instructions and tips to help you. After you have completed all of these steps, you can check on the status of your application at any time, but you will also be notified via e-mail.  http://uhg.hr/OurApplicationProcess Primary Responsibilities Review, research, analyze and process complex healthcare claims by navigating multiple computer systems and platforms and accurately capturing the data/information for processing (e.g. verify pricing, prior authorizations, applicable benefits) Ensure that the proper benefits are applied to each claim by using the appropriate tools, processes and procedures (e.g. claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/ certificates tool) Independently on a daily basis completes all data entry for all documentation and communicate the status of claims adhering to reporting requirements Communicate through correspondence with members and providers regarding claim payment or required information using clear, simple language to ensure understanding Learn and leverage new systems and training resources to help apply claims processes/procedures appropriately (e.g. on-line training classes, coaches/mentors) Meet and maintain the performance goals established for the position in the areas of quality, production and attendance 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 An education level of at least a high school diploma or GED OR equivalent years of work experience Proficiency with Windows PC applications, which includes the ability to navigate multiple programs and learn new and complex computer system applications Ability to learn understand multiple products and multiple levels of benefits within each product Consistent attendance with ability to meet work schedule including the required training period Successful completion of the UnitedHealth Group 12-14 week new hire training program which is 60% instructor lead and 40% self-paced learning (requires ability to read complex information and demonstrate proficiency through testing and practical application) Preferred Qualifications 1+ year of experience in a related environment (i.e. office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools 1+ year experience processing medical, dental, prescription or mental health claims Making claims a positive experience for our members can drive your sense of impact and purpose. Join us as we improve the lives of millions.  Learn more about how you can start doing  your life’s best work. SM Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 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 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: medical claims, healthcare claims, claims representative, claims rep, claims processing, claims processor; UnitedHealth Group, UnitedHealthcare, training class, office, clerical, customer service

Keywords: UnitedHealth Group, Tonawanda , Customer Support Specialist, Other , Tonawanda, New York

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