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. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.As a Data Analyst you will be responsible for validating savings from our prepayment review on both high dollar inpatient and outpatient claims for UnitedHealthcare. To do this you will review claims within the UHC system comparing our review data to ensure claims were processed accordingly and validate the savings on these claims. You will be responsible for ensuring these claims are sent to invoicing for payment and document savings on the claims. This requires heavy excel work so you must be proficient in excel.You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities:
UHC savings validations at the claim level
Accessing and reviewing claim adjustments were made properly
Ensuring claims are sent to invoices for payment on our review
Ensuring all data elements are correct for proper documentation of revenue
Assesses and interprets customer needs and requirements
Identifies solutions to non-standard requests and problems
Provides explanations and information to others on difficult issues
Acts as a resource for others with less experience
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.Required Qualifications:
3+ years of experience using Excel, pivot tables, data validation etc.
2+ years of experience with claim investigation
2+ years of experience using reporting tools like Tableau, SSRS, Power BI or others
2+ years of experience using UHC systems: UNET and CIRRUS
1+ years of CMRT claim processing experience
Proven critical thinking
Preferred Qualifications:
Data visualization experience
Claim investigation experience
Works with minimal guidance; seeks guidance on only the most complex tasks
Experience working in both Agile and Waterfall approaches within systems
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter PolicyPay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $71,200 to $127,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.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.UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
