Job Closed
This listing is no longer active.
UnitedHealth Group is a healthcare and well-being company that’s dedicated to improving the health outcomes of millions around the world. We are comprised of
Claims Representative
Location
United States
Posted
4 days ago
Salary
$18 - $32 / hour
Seniority
Mid Level
No structured requirement data.
Job Description
Claims Representative
UnitedHealth Group
Role Description This position is National Remote. You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. The Claims Representative / Insight Analyst Assistant primary duties may include but are not limited to: - Initiating and managing tasks associated with case workflow. - Adhering to protected health information rules and regulations on behalf of our clients. This position is full time, Monday - Friday. Employees are required to have flexibility to work any of our shift schedules during our normal business hours of 8:00 am - 5:00 pm. This will be paid on-the-job training during normal business hours, Monday - Friday. Primary Responsibilities: - Process medical record submissions through various avenues. - Manage cases from the time of opening to the time medical records are received, including verification and management of standard turn-around times on cases, or the case is closed for NMR. - Act as a Subject Matter Expert (SME) and provide exceptional communications with Providers. - Maintain the ability to work in an environment with PHI. - Understand and adhere to HIPAA privacy requirements. - Other duties as assigned. 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. Qualifications - High School Diploma / GED. - Must be 18 years of age OR older. - 1+ years of customer service experience. - Experience with Microsoft Word (create correspondence and work within templates), Microsoft Excel (data entry, sort / filter, and work within tables), and Microsoft Outlook (email and calendar management). - Ability to work any of our full-time, shift schedules during our normal business hours of 8:00 am - 5:00 pm from Monday - Friday. Requirements - 1+ years of experience in healthcare related OR healthcare claim industry. Telecommuting Requirements - Ability to keep all company sensitive documents secure (if applicable). - Required to have a dedicated work area established that is separated from other living areas and provides information privacy. - 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 - Strong verbal and written communication. - Requires a commitment to confidentiality, privacy, and professionalism. - Ability to work independently and as a team member. - Self-motivation, flexible, strong time management, organizational, and analytical skills. - Must be detail oriented and possess the ability to multi-task. - Experience with working in a fast-paced professional environment. Benefits - Pay 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). - The hourly pay for this role will range from $18 - $32 per hour based on full-time employment. 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.
Related Guides
Related Categories
Related Job Pages
More Claims Specialist Jobs
Material Specialist
Micron TechnologyMicron Technology specializes in memory and semiconductor technology, such as computer memory and image sensors. Since opening, Micron Technology has had a successful history and i
Our vision is to transform how the world uses information to enrich life for all . Micron Technology is a world leader in innovating memory and storage solutions that accelerate the transformation of information into intelligence, inspiring the world to learn, communicate and advance faster than ever. Job Responsibilities and Tasks: - - Understand All Aspects of Material Handling - Know all responsibilities of material handling. - Work independently in area of assignment. May be assigned to a specialized function. - Document and complete area/shift projects. - Understand and utilize personal computer application and other programs necessary for assigned functions and projects. - Research and reconcile inventory discrepancies, receiving and issuing errors, and accounting problems. - Organize/prioritize daily, weekly, and monthly duties with minimal supervision. - Hands on experience into SAP, Knowledge for SEZ operation is an added advantage. - Handle day-to-day conflicts as necessary. Know when to elevate issues to supervisor/manager level. - Coordinate team projects, including quality and system/procedure improvements. - Participate in cross functional team as a department representative if needed. - Assist with new program/procedure implementation. - Assist supervisor with daily scheduling (breaks, time off, classes, projects, etc.). - Understand and promote department policies and philosophies. - Develop a leadership role in a specific area or shift. - Demonstrate Communication Skills - Communicate with the purchasing department buyers, planners, supervisors, and key customer contacts to resolve issues and complete tasks. - Submit clear, concise notes, documentation, and meeting minutes. - Present written and verbal information clearly and effectively. - Adhere to and Promote Safety - Identify and promptly report hazards. - Follow safety procedures and area work rules including proper PPE, lockout and chemical safety. - Operate and maintain equipment and tools within manufacturers and company guidelines. - Use proper lifting techniques and work in an ergonomically correct manner. - Participate in Recommended Training Classes or Equivalents Education and Experience Requirements: - Diploma in any specialization with 2+ years of relevant experience. OR ITI in any specialization, with 5+ years of relevant experience. OR B.Com, with 2+ years of relevant experience. About Micron Technology, Inc. We are an industry leader in innovative memory and storage solutions transforming how the world uses information to enrich life for all . With a relentless focus on our customers, technology leadership, and manufacturing and operational excellence, Micron delivers a rich portfolio of high-performance DRAM, NAND, and NOR memory and storage products through our Micron® and Crucial® brands. Every day, the innovations that our people create fuel the data economy, enabling advances in artificial intelligence and 5G applications that unleash opportunities - from the data center to the intelligent edge and across the client and mobile user experience. To learn more, please visit micron.com/careers All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status. To request assistance with the application process and/or for reasonable accommodations, please contact hrsupport_india@micron.com Micron Prohibits the use of child labor and complies with all applicable laws, rules, regulations, and other international and industry labor standards. Micron does not charge candidates any recruitment fees or unlawfully collect any other payment from candidates as consideration for their employment with Micron. AI alert: Candidates are encouraged to use AI tools to enhance their resume and/or application materials. However, all information provided must be accurate and reflect the candidate's true skills and experiences. Misuse of AI to fabricate or misrepresent qualifications will result in immediate disqualification. Fraud alert: Micron advises job seekers to be cautious of unsolicited job offers and to verify the authenticity of any communication claiming to be from Micron by checking the official Micron careers website in the About Micron Technology, Inc.
Lead Follow-Up Specialist
Get Linked up LLCIf you are a dedicated and experienced Personal Injury Case Manager ready to take on a vital role remotely, we encourage you to apply confidentially. Join our network of exceptional case managers making a real difference!
Role Description We are seeking a Bilingual Real Estate Lead Follow-Up Specialist to support a residential real estate firm by contacting and nurturing incoming leads. The firm provides the leads through multiple channels, including phone calls, emails, online inquiries, and event sign-ups. Your role is to promptly contact these leads, qualify them, build rapport, and ensure consistent follow-up to move them through the pipeline. This is a remote position ideal for someone who is disciplined, self-motivated, and comfortable working independently while maintaining high productivity. Comfortable speaking to clients on the phone, and doing inside sales. 90% will be Spanish speaking clients! - Make outbound calls to new and existing real estate leads provided by the firm - Respond to inbound inquiries via phone, email, and CRM systems - Conduct consistent follow-up to nurture leads over time - Qualify prospects and gather key information - Schedule appointments or hand off qualified leads to the real estate team - Update and maintain accurate records in the CRM - Track follow-up tasks and ensure no leads fall through the cracks - Represent the client professionally and provide excellent customer service Qualifications - Bilingual (English and Spanish required) - Previous experience in lead calling, inside sales, customer service, or real estate preferred - Strong phone communication and interpersonal skills - Comfortable making high-volume outbound calls - Highly organized, detail-oriented, and disciplined - Self-starter who can work independently in a remote environment - Reliable internet connection and quiet home workspace - Ability to work the required schedule: 10:00 AM – 7:00 PM EST Requirements - Experience working with CRMs (real estate CRMs a plus) - Real estate or sales background - Appointment setting or lead qualification experience Benefits - Fully remote / work-from-home position - Consistent schedule - Opportunity to work with a growing residential real estate firm
Mental Health Specialist - General Adult Unit
Mass General BrighamMass General Brigham connects a full spectrum of care across a system of academic medical centers, specialty and community hospitals, physician networks, a heal
Title: Mental Health Specialist - General Adult Unit Onsite locations Belmont-MA time type Part time job requisition id RQ4068157 Job Description: Site: The McLean Hospital Corporation Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. Job Summary Under direction of the Registered Nurse, the MHS provides direct patient care and participates in therapeutic milieu. Does this position require Patient Care? Yes Essential Functions Assists the RN in providing direct patient care. 1. Accurate and timely documentation of AFS, progress notes, and observation sheets. 2. Establishes therapeutic relationships with patients, maintaining professional boundaries. 3. Participates in patient rounds or teams. 4. Completes patient care assignments. 5. Identifies patient behaviors that contribute to the development of a crisis; utilizes non-verbal and verbal. 6. Techniques to de-escalate crisis situation. 7. Intervenes in managing complex patient situations and patient schedules, utilizing department policies and procedures, always promoting the least restrictive alternatives. 8. Communicates changes in patient status to RN. 9. Follows Standards of Care and protocols for assigned patients. 10. Remains awake and alert at all times while on the job. 11. Performs Point of Care testing (POC). Works effectively in the therapeutic milieu. 1. Participates in planning and implementation of patient groups. 2. Provides and supervises recreation and other off-hall activities according to needs. 3. Provides patients with direction, support, and supervision as needed. 4. Follows established Nursing policies, procedures, and protocols. 5. Active milieu assessment while assigned to checks, particularly attuned to safety concerns. Participates in the maintenance of the unit environment to ensure safe care. 1. Identifies and reports house cleaning problems to Unit Secretary/ND. 2. Identifies and reports equipment problems to Unit Secretary/ND. 3. Participates in the unit’s inventory system, reporting when supplies are low. 4. Initiates activities that assist patients in maintaining a clean environment. 5. Initiates activities that promote an organized, safe patient and staff environment. Assists patients in their activities of daily living. 1. Identifies patient hygiene needs; initiates and implements interventions to meet these needs. 2. Provides for patients’ nutritional needs according to unit procedure. 3. Assists and reassures patients during tests, exams, and procedures. 4. Escorts and supervises patients on and off ground, maintaining patient safety. Maintains a commitment to professional growth and competency. 1. Completes mandatory in-service requirements. 2. Identifies areas of strengths and areas in need of professional development with supervisor. 3. Maintains competency for treating age-specific patient populations. 4. Seeks constructive feedback, regarding work performance, from peers and professional colleagues. 5. Participates in critical incident de-briefing. Qualifications Education High School Diploma or Equivalent required Can this role accept experience in lieu of a degree? No Licenses and Credentials Experience One year of clinical experience, preferably in a psychiatric setting 1-2 years preferred and Previous experience in direct patient care preferred preferred Knowledge, Skills and Abilities - Verbal and written communication skills, and ability to work in collaboration with others. - Must complete and pass Epic training within 30 days of hire. - Successful passing (80% or higher) of Epic training modules(s) is a minimum requirement of the job. Additional Job Details (if applicable) The adult inpatient unit (NB1) is a generalized inpatient psychiatric unit with a primary focus on the treatment of depression and anxiety. We also care for patients with a wide range of psychiatric disorders, including OCD, bipolar disorder, personality disorders, self-harming behaviors, homicidally, and co-occurring substance use disorders. Our team provides patient-centered care through therapeutic engagement, medication management, and behavioral interventions in a supportive, team-based environment." Remote Type Onsite Work Location 115 Mill Street Scheduled Weekly Hours 0 Employee Type Per Diem Work Shift Rotating (United States of America) Pay Range $22.40 - $29.73/Hourly Grade MCL050 At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.
Claims Resolution Specialist I
Baptist Health System, Inc.Recognized as a top place to work in health care, Baptist Health cares for more patients in Northeast Florida than any other provider, ranking as “most preferred” for more than 30 years. We’re Jacksonville's only locally governed, faith-based, not-for-profit health system and provide a full spectrum of preventive and specialty care through 200+ locations and six hospitals. Our centers of excellence include Baptist MD Anderson Cancer Center, Baptist Heart Hospital, Baptist Neurological Institute and Wolfson Children's Hospital.
Role Description Baptist Metro Square currently hiring for a Full-Time Claims Resolution Specialist I to join our team here in Jacksonville. As a Claims Resolution Specialist I, you will be responsible for: - Appropriately resolving each medical claim sent to commercial insurance companies, third party organizations and/or government payers. - Having experience and demonstrated competency in at least 2 of the following areas within the revenue Cycle: Registration, Eligibility, Charge Capture, Clearinghouse, Payment Posting, Claim Denial, and Credit Management. - Analyzing explanation of benefits to ensure proper payment to Baptist Health from paying entities. - Communicating with third-party representatives as necessary to complete claims processing and/or resolve problem claims. - Following up daily on post processing activity including but not limited to, rejected billings, adjustments, corrected claims, overpayments, and denied claims. - Working all assigned accounts on worklist in order depending on balance and age. - Identifying and communicating trends in denials to leadership. - Communicating with various departments to resolve any outstanding issues with claims to resolve denials. - Possessing up-to-date knowledge related to CPT codes, ICD/10 codes. Qualifications - 1-2 years Customer Service Experience Required - 1-2 years Healthcare experience required - 1-2 years Insurance experience required Requirements - High School Diploma Required Company Description Recognized as a top place to work in health care, Baptist Health cares for more patients in Northeast Florida than any other provider, ranking as “most preferred” for more than 30 years. We’re Jacksonville's only locally governed, faith-based, not-for-profit health system and provide a full spectrum of preventive and specialty care through 200+ locations and six hospitals. Our centers of excellence include Baptist MD Anderson Cancer Center, Baptist Heart Hospital, Baptist Neurological Institute and Wolfson Children's Hospital.
