Appeals Representative – Multiple Locations Job Vacancy in UnitedHealth Group Noida, Uttar Pradesh – Updated today
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Full Details :
Company Name : UnitedHealth Group
Location : Noida, Uttar Pradesh
Position :
Job Description : Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that’s improving the lives of millions. Here, innovation isn’t about another gadget, it’s about making health care data available wherever and whenever people need it, safely and reliably. There’s no room for error. Join us and start doing your life’s best work.(sm)
This position will be responsible for handling highly escalated claim reimbursement disputes from providers for all 3 lines of businesses – Commercial / Medicare / Medicaid. Resource would be collaborating with different UHC / Optum resolution partners to gather relevant information and will share a final decision on the claim disputes with the providers either through email or a direct phone call. Hence, it is imperative that candidate should have excellent communication skills and should be highly detail oriented because of the complexities involved in claim research as well as claim adjustment. This profile will be a blended profile with up to 50% of the time required for calling US physicians / hospitals to share the decision rationale on their claim disputes.
Primary Responsibility:
Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so
Required Qualifications:
Graduation
12+ months of prior experience of working in US healthcare claims and/or claims adjustment process
12+ months of experience in calling US providers / insurance companies in US healthcare process
Ability to understand and apply plan concepts to include:
Deductible
Coinsurance
Copay
Out-of-pocket
Maximums, inside limits and exclusions
State variations
Ability to recognize issues related to variable deductible, coordination of benefits, carve-out and alternate benefits
Ability to adhere to quality improvement initiatives
Ability to demonstrate increasing productivity to meet minimum requirements while maintaining quality standards
Preferred Qualifications:
Excellent verbal communication skills in English and US healthcare process understanding
Working knowledge of MS Office and PC Skills
Effective time management
Detail oriented, good analytical and research skills and process adherence orientation
Open to work in any shifts allocated including proper night shifts
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)
This post is listed Under Healthcare
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