Claims Analyst - Trumbull, CT; Cypress, CA

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.UnitedHealthcare, a UnitedHealth Group company, provides network-based health and well-being benefits and services for employers and consumers nationwide. We use our strength, diversity and innovation to improve the lives of the more than 18 million people who receive our unique products and services. And our endless pursuit for excellence in everything we do extends to your career as well. Join us today for an inspired and purposeful mix of professional growth opportunities and personal rewards.Primary Responsibilities: Process repricing inquiry adjustments, conduct analysis of data, identify trends, determine root causes, provide reports as appropriate for claim teams, and ensure quality improvement. Responsible for processing both simple and complex (includes specialty) adjustments. Identify the nature of the Pricing error (e.g., incorrect Fee Schedule or Market Code, wrong provider suffix). Determine appropriate action needed for inquiry resolution (e.g., corrected repricing sheet, provider call or letter). Perform all necessary steps related to individual inquiry processes. Determine corrective action needed based on nature of error and process adjustment. Handle all necessary correspondence appropriate for the underpayment, overpayment (e.g., follow-up notifications). Adhere to quality improvement initiatives. Identify trends. Determine root causes. Partner with training team to deliver training based on trending of errors and adjustments. Provide on-going feedback for utilization in individual and team development.Qualifications: High school diploma or equivalency required. 1 year PC software skills (e.g., Word, Excel) required. 3 - 5 years experience with claims processing systems, interfaces and supporting systems utilized in the claim payment process required. Production environment experience preferred. Customer Service experience preferred. Access data base experience preferred. Re-pricing experience is preferred. Knowledge around contracting is a plus.Diversity creates a healthier atmosphere:  equal opportunity employer M/F/D/VUnitedHealth Group is a drug-free workplace.  Candidates are required to pass a drug test before beginning employment.