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Claims Analyst - Saint Charles, IA
| Details |
Country: USA
Location: Iowa-Central/Des Moines Des Moines, IA
Total applied: 6 |
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Claims Analyst - Saint Charles, IA
UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.J.W. Hutton delivers Intelligence for Health Care. A UnitedHealth Group company, we unite the brightest minds to transform organizations and improve health care through information and technology. We serve a diverse customer base within the health care community, including health care payers, providers, employers, pharmaceutical companies, consumers, workers’ compensation and auto liability insurers, and government agencies. Primary Responsibilities: Manage caseload of overpayment recovery files on behalf of our clientele. Communicate with providers of service, members, attorneys, and pharmacies to obtain reimbursement of claim overpayments. Negotiate settlements of overpayment claims within the scope of authority extended by our clients. Make recommendations for litigation to clients when all recovery or settlement options are exhausted. Maintain accurate records of all communications and payments. Strictly adhere to all state and federal laws, rules, and regulations pertaining to the pursuit of third party liability claims. Apply knowledge/skills to basic, repeated activities. Demonstrate minimum depth of knowledge and skills in own function. Respond to standard requests. Require assistance in responding to non-standard requests. Solve routine problems by following established procedures. Others prioritize and set deadlines for employee. Work with others as part of a team. Qualifications: 1 year of customer service experience in an office or call center environment is required. High school/GED is required. PC proficiency is required. Experience within the insurance industry is highly preferred, experience with negotiations is a plus!Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V.
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