Claims Quality/Audit Representative – Remote Job Vacancy in UnitedHealth Group Phoenix, AZ 85070 – Latest Jobs in Phoenix, AZ 85070

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Company Name : UnitedHealth Group
Location : Phoenix, AZ 85070
Position : Claims Quality/Audit Representative – Remote

Job Description : You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
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 Healthcare 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
Employees in this position will work on-site or virtually as an extension of the local quality and provider teams by aligning to geographical regions, medical centers and/or physician practices that manage a high volume of UHC Medicare & Retirement membership. This position does not entail any direct member care nor does any case management occur.
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 of (7:30am-5:00pm PST or MST). It may be necessary, given the business need, to work occasional overtime.

All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Position Summary:
This position is responsible for conducting a quality review of all Optum external documents, internal process review and reporting quality assurance results. This position also conducts research as required to support audit exceptions and resolve issues.
General Duties and Responsibilities:

Conduct quality reviews of all eligible Equian external documents, to include Forensic Reports, Appeal Responses and calculations, Reports delivery to clients and providers
Complete miscellaneous production-related tasks as required for support including: scan records, process triage forms and process referrals.
Perform research to support quality review findings, exceptions and resolve issues
Perform research to create new exceptions and business rules, process improvement suggestion and review
Understand and maintain HIPAA confidentiality and privacy standards when completing assigned work
Participate in department and company meetings as requested
Complete special projects as assigned

Primary Duties: (In order of importance): Approximate % of time required

Daily Review of Production – maintain key TAT with production assistance 90%
Training, Review and Implementation of Processes 10%

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) OR equivalent experience
1+ years of experience in medical billing/coding, claims review, accounting or finance
1+ years of experience in quality review/assurance
Flexibility to work any of our 8 hour shift schedules during our normal business hours of (7:30am-5:00pm PST or MST)

Preferred Qualifications

Familiarity with medical terminology and coding
Advanced computer skills, specifically Microsoft Excel (formulas, pivot tables, edit/create spreadsheet / ability to create, edit, copy, send and save spreadsheet)

Telecommuting Requirements:

Required to have a dedicated work area established that is separated from other living areas and provides information privacy
Ability to keep all company sensitive documents secure (if applicable)
Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

Soft Skills

Strong organizational skills and attention to detail
Excellent analytical skills
Ability to multi-task and work with little direction. A self-starter.
Good verbal and written communication skills
Team player demonstrating enthusiasm and commitment to company vision and mission
Ability to be a positive representative of the Company both internally and externally.
Ability to work with respect and cooperation at all times with fellow employees and clients.

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.
Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at https://uhg.hr/transitioning-military
Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible. https://uhg.hr/vet
Careers with OptumInsight. Information and technology have amazing power to transform the Healthcare industry and improve people’s lives. This is where it’s happening. This is where you’ll help solve the problems that have never been solved. We’re freeing information so it can be used safely and securely wherever it’s needed. We’re creating the very best ideas that can most easily be put into action to help our clients improve the quality of care and lower costs for millions. This is where the best and the brightest work together to make positive change a reality. This is the place to do your life’s best work.SM
Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $15.00 to $25.19. The salary range for Connecticut / Nevada residents is $15.77 to $27.79. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives
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.
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