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UnitedHealth Group Quality Claims Analyst Tampa FL Hybrid in Tampa, Florida

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work.(sm)

Positions in this family support claim processing functions including investigations, negotiating settlements, payments, research regarding eligibility, etc.

If you are located in Tampa, FL, you will have the flexibility to work remotely*, as well as work in the office as you take on some tough challenges.

Primary Responsibilities:

  • Reviews claims for data entry accuracy

  • Understands, interprets and applies business policies and procedures related to claims, auditing and data entry

  • Analyzes data to identify error trends and reports results

  • Maintains current knowledge of CMS and HIPPA regulations.

  • Complies with deadlines to ensure audit cycles are completed and reported timely.

  • Performs all other related duties as assigned

  • Demonstrate working knowledge of how to utilize and navigate applicable claims processing system used internal database

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 or GED

  • 2+ years of claims processing experience

  • Utilize experience, knowledge and judgment to plan, accomplish goals and effectively solve problems

  • Commonly used knowledge of claims examination concepts, practices and rules, ICD and CPT coding

  • Medical terminology, 10-key and computer literacy

  • Proficient with CMS 1500 and UB92 claim forms

Preferred Qualifications:

  • Knowledge of enterprise-wide claims management software

  • Knowledge of IKA claim and DocDNA claim systems

  • Exceptional ability to organize, prioritize and communicate effectively

  • Performs a variety of tasks that may require a limited degree of creativity and latitude

Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

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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