Recovery Resolutions Analyst - Eden Prairie, MN (576317) $40-$45K Post Pay Non-Clinical Intake Analyst - Eden Prairie, MN (580622) $40-$45K Primary Responsibilities: - Review suspect claim submissions to identify suspect or aberrant billing patterns - Request Medical Records - Complete Comprehensive Investigative Reports - Conduct provider license checks utilizing various investigative sources. - Communicate and identify new aberrant claim activity to other related departments - Conduct member/provider telephonic interviews. - Submit suspect providers for reporting, to the Department of Insurance or appropriate Medical Board - Collaborate with clinical, and/or legal on case strategies - Identify new suspect providers - Identify opportunities to inactivate, or modify current flags, or edits - Review Monthly Add/Delete Reports - Liaison with customer for case specific inquiries Requirements: - High School Diploma/GED - 2+ years work experience in the healthcare insurance industry - 2+ years experience with healthcare claims processing or data entry - Intermediate level of proficiency with MS Excel - Experience working in a production environment 1) Apply directly on unitedhealthgroup 2) For faster & easier job locator, type in the 6 digits in the career search box 3) Feel free to utilize me as reference: pangda.lee@optum
Posted on: Mon, 22 Dec 2014 17:25:27 +0000
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