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UnitedHealth Group
Wausau, Wisconsin, United States
18 hours ago

Description

Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work. SM

The Claims Clerk is responsible for providing expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting claims.

This position is full-time (40 hours/week) Monday – Friday. Employees are required to work our normal business hours of 8:00am – 5:00pm. Our office is located at115 W Wausau Avenue, Wausau, WI 54401.

Primary Responsibilities:
  • Provide general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims.
  • Authorize the appropriate payment or refers claims to investigators for further review.
  • Conduct data entry and re-work; analyzes and identifies trends and provides reports as necessary.
  • Analyze and identify trends and provide reports as necessary
  • Consistently meet established productivity, schedule adherence, and quality standards
  • Recognize claims by determining claim type – HCFA, Hospital, UB, and/or RX
  • Identify more complicated claims and refer them to Senior Claim Processor or Supervisor
  • Calculate other insurance and re-pricing benefits
  • Work claims files to ensure the appropriate eligibility and provider records are matched to the claim
  • Updates and maintains claims tracking database

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 (or higher)
  • 2+ years of data entry experience
  • 1+ years of experience in an office setting environment using the telephone and computer as the primary instruments to perform job duties
  • Basic proficiency with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
  • Basic understanding of healthcare claims including ICD-9 and CPT codes
  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

Preferred Qualifications:
  • 1+ years of experience working with medical claims
  • 1+ years of working in production based environment
  • Ability to type 60+ WPM

Physical Requirements and Work Environment:
  • Extended periods of sitting at a computer and use of hands/fingers across keyboard or mouse
  • Office environment

Soft Skills:
  • Ability to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each product

UnitedHealth Group is an essential business. The health and safety of our team members is our highest priority, so we are taking a science driven approach to slowly welcome and transition some of our workforce back to the office with many safety protocols in place. We continue to monitor and assess before we confirm the return of each wave, paying specific attention to geography-specific trends. We have taken steps to ensure the safety of our 325,000 team members and their families, providing them with resources and support as they continue to serve the members, patients and customers who depend on us. You can learn more about all we are doing to fight COVID-19 and support impacted communities at: https://www.unitedhealthgroup.com/newsroom/addressing-covid.html

Take the next step, online at: www.yourlifesbestwork.com

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.

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 10 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: claims, data entry, coding, medical coding, customer service representative, customer service, CSR, UnitedHealth Group, Optum, OptumRx, call center, UnitedHealthcare, health care, healthcare, office, phone support, training class, advocate, hiring immediately, #rpo


Requisition #: 935622

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Job Information

  • Job ID: 57894500
  • Location:
    Wausau, Wisconsin, United States
  • Position Title: Claims Clerk - Wausau, WI
  • Company Name: UnitedHealth Group
  • Job Type: Full-Time
Insurance
CA , US

At UnitedHealth Group, the mission is to help people live healthier lives. To achieve this goal, we are focused on building a modern, adaptable, innovative and inclusive system of health care services. Our scale and potential to improve health makes us one of the most visible stewards of America’s vast health care system. Entrusted with both important resources and responsibilities, we are involved on a daily basis in decision-making that has life-changing consequences for millions of Americans.

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