recovery and resolutions Manager, taguig, ncrUnitedHealth Group

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm) The health care system is still evolving at a rapid pace. Technology is driving new advances in how patient care is delivered and how it's reimbursed. Now, UnitedHealth Group invites you to help us build a more accurate and precise approach to claims adjudication. As part of our Recovery and Resolutions team, you'll provide consultative support to our business units and external vendor organizations. You'll handle requests, define business requirements and coordinate resolutions incorporating State/Federal regulations. Join us and build your career with an industry leader. This is a challenging role with serious impact. You'll be assisting, educating, problem-solving and resolving challenging situations to the best possible outcomes. You'll need to understand and interpret clients' needs and ensure service and delivery excellence supporting the Fraud, Waste, Abuse, and Error product suite. This involves working with a high complexity solution set and cross functional teams to proactively review, research and resolve highly escalated inquiries. Primary Responsibilities: Define and document/communicate business requirements Analyze scope and resolution of medium to large Operations Management (OM) and development requests Serve as a key resource on complex and/or critical issues and help develop innovative solutions Perform complex conceptual analyses Serve as a key resource on complex and/or critical issues and help develop innovative solutions Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so Required Qualifications: Graduate of any 4 year course 2+ years of experience working in negotiations, mediations, and / or arbitrations preferably in the health insurance business 2+ years of experience analyzing and solving problems 2+ years of experience using claims platforms such as UNET, Pulse, NICE, Facets, Diamond, etc. 12 months in current role/tenure Proficiency using MS Excel (data entry, sorting/filtering, pivot tables) and PowerPoint No active CAP/PIP Preferred Qualifications: Graduate of Allied Medical 1+ years of experience in health care claims recovery Understanding of medical coding methodologies
Monster

Taguig City, Metro Manila
Permanent
Full-time