Claims Quality/Audit Representative - Irvine, 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.Prescription Solutions helps consumers obtain the medications and products they need to live healthier lives. Services offered by the company include pharmacy network contracting, rebate contracting and administration, mail order pharmacy facilities, specialty drugs and retail drug claims processing.  The company is one of only three in the United States to have received URAC dual accreditation and provides clinical services to help its clients provide cost effective, quality-driven results.  The company is part of Pharmacy Services group, within Enterprise Services, a family of UnitedHealth Group businesses dedicated to improving the health and well-being of Americans.   Primary Responsibilities: Processing and troubleshooting eligibility files. Coordinating changes with clients. Verifying and researching information as needed. Acting as a liaison between the client management and the development team.Qualifications:  2-3 years experience in Customer Service or Claims required. Ability to learn technical details and relay those details to non-technical people required. MS/Office (Word, Excel & Outlook) required. Basic Math skills required. AS/400 and/or Visio preferred. Auditing or troubleshooting experience is preferred. Eligibility experience is preferred. Bachelor’s degree is preferred.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.