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Senior Claims Business Process Analyst - Remote in California

Company: UnitedHealth Group
Location: Los Angeles
Posted on: November 26, 2022

Job Description:

If you are located within California, you will have the flexibility to telecommute (work from home) as you take on some tough challenges. Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work. SM Flexible, Friendly, Fast on your feet, that's a great start. Accurate, Accountable, Self-Directed; These traits can take you places. Our claims operations are the focal point of handling information about services patients receive and they way those services get paid. It's complex, detailed work. It's fast paced challenge. It's a job that calls on you to be thoughtful, resourceful, team-driven and customer-focused. To put it mildly, there is never a dull moment. Senior Claims Business Process Analysts are responsible for all related aspects of claim system processes and claim business rules. Include claims systems utilization, capacity analyses/planning and reporting, claims-related business and systems analysis. Ensure data integrity, data security and process optimization. This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of (8:00am - 5:00pm). It may be necessary, given the business need, to work occasional overtime and/or weekends. Primary Responsibilities:

  • =Responsible for providing research and root cause analysis for claim quality remediation
  • Perform capacity planning and reporting
  • Responsible for all aspects of quality assurance
  • Create and edit requirements, specifications, cost benefit analysis and recommendations to proposed solutions
  • Facilitate development of process documentation
  • Follow standard programming guidelines and requirements as set by tea
  • Standard documentation and tracking processes
  • Uses pertinent data and facts to identify and solve a range of problems within area of expertise 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 / GED (or higher)
    • 2+ years of experience analyzing and solving customer problems in an office setting environment
    • 3+ years in a technical or metrics-based environment; preferably claims and/or customer service
    • Moderate proficiency with computer and Windows PC applications, which includes the ability to learn new complex computer system applications
    • Ability to work an 8-hour shift Monday-Friday from 8:00am to 5:00pm Preferred Qualifications:
      • Associate's Degree (or higher)
      • 2+ years of UNET claim experience
      • 1+ years of COMET experience
      • 2+ years of Adjustment
      • Macro development
      • Intermediate level of Microsoft Visio (create, edit, format, manipulate data)
      • SharePoint development/creation Telecommuting Requirements:
        • Reside within California
        • Required to have a dedicated work area established that is separated from other living areas and provides information privacy
        • Ability to keep all company sensitive documents secure (if applicable)
        • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service Soft Skills:
          • Ability to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each product
            UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status. Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible. Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health - related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work. SM 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.

Keywords: UnitedHealth Group, Los Angeles , Senior Claims Business Process Analyst - Remote in California, Professions , Los Angeles, California

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