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Senior Claims Business Process Analyst - Irvine, CA
IRVINE CA 92604
Category: Health Care Industry , Insurance
  • Your pay will be discussed at your interview
  • Already one of the world's leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up. This opportunity is with one of our most exciting business areas: Optum -a growing part of our family of companies that make UnitedHealth Group a Fortune 6 leader.
    Employees in jobs labeled with SCA must support a government Service Contract Act (SCA) agreement.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 team Standard documentation and tracking processes Uses pertinent data and facts to identify and solve a range of problems within area of expertise Ability to work quickly and accurately under time constraints, working independently with strong team collaboration skills Math, proofreading, computer and accounting aptitude Excellent analytical skills, solutions orientatedKnowledge of current Med D compliance guidance and regulations Ability to handle sensitive material confidentially Analyzes and investigates Provides explanations and interpretations within area of expertise Required Qualifications: High School Diploma / GED or higher 2+ years of experience analyzing and solving customer problems in an office or Pharmacy environment 2+ years of experience in a technical or metrics based environment Preferred Qualifications: Associate's Degree or higher 3+ years of Pharmacy Benefits experience Knowledge of Medicare Part D compliance and regulations Rx Claims Processing experience Licensed Pharmacy Technician Quality Audit or Appeals experience Soft Skills: Excellent Analytical skills Strong written and verbal communication skills Ability to work independently Ability to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each project OptumRx is an empowering place for people with the flexibility to help create change.

Job code: lhw-e0-90671450

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  Job posted:   Thu Jun 7, 2018
  Distance to work:   ? miles
       
  16 Views, 0 Applications  
 
Senior Claims Business Process Analyst - Irvine, CA
Energize your career with one of Healthcare's fastest growing companies. You dream of a great career with a great company - where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it's a dream that definitely can come true.
Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals.
No other business touches so many lives in such a positive way.
And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance. 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.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.Positions in this function are responsible for all related aspects of claim system processes and claim business rules.
Includes claims systems utilization, capacity analyses / planning and reporting.
Includes claims-related business and systems analysis.
Ensures data integrity, data security and process optimization.
Innovation is part of the

job description.
And passion for improving the lives of our customers is a motivating factor in everything we do.
If you're ready to talk about groundbreaking interactions, let's talk about what happens when a firm that touches millions of lives decides to gather results from millions of prescriptions every month and analyze their impact.
Let's talk about smart, motivated teams.
Let's talk about more effective and affordable healthcare solutions.
This is caring.
This is great chemistry.
This is the way to make a difference.
We're doing all this, and more, through a greater dedication to our shared values of integrity, compassion, relationships, innovation and performance. Join us and start doing your life's best work.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: claims, medical claims, healthcare claims, claims processing, claims processor, office, UnitedHealth Group, UnitedHealthcare, training class, customer service representative, customer service, CSR, data entry, adjustments, phone support b449d035-710a-49a3-bbf4-e2f0a1a38d1a
*Senior Claims Business Process Analyst - Irvine, CA*
*California-Irvine*
*769357*

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