UnitedHealth Group Hiring for Claims Clerk – Work From Home at San Antonio, TX Full Time

If you are located within 50 miles from Wausau, WI and/or 30 miles from San Antonio, TX, 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

The Claims Clerk is responsible for providing expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting claims.

First two weeks you will be required to work on site, training is virtual and after training you have a choice to work onsite or work remote.

Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am – 4:30pm CST. It may be necessary, given the business need, to work occasional overtime or weekends.

We offer 6 to 8 weeks of paid training. The hours during training will be 6:30am – 9:00pm CST. Training may be conducted with the supervisor in the office or virtually from your home.

• All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary Responsibilities:

• Provide general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims.
• Authorize the appropriate payment or refers claims to investigators for further review.
• Conduct data entry and re-work; analyzes and identifies trends and provides reports as necessary.
• Analyze and identify trends and provide reports as necessary
• Consistently meet established productivity, schedule adherence, and quality standards
• Recognize claims by determining claim type – HCFA, Hospital, UB, and/or RX
• Identify more complicated claims and refer them to Senior Claim Processor or Supervisor
• Calculate other insurance and re-pricing benefits
• Work claims files to ensure the appropriate eligibility and provider records are matched to the claim
• Updates and maintains claims tracking database

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)
• Experience working in office environment

Telecommuting Requirements:

• Reside within 50 miles from Wausau, WI and/or 30 miles from San Antonio, TX
• 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

Preferred Qualifications:

• 2+ years of data entry experience
• 1+ years of experience working with medical claims
• 1+ years of working experience in production based environment
• Basic proficiency with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
• Basic understanding of healthcare claims including ICD-9 and CPT codes
• Prior experience working with IDX software
• Type 60+ words per minute

Soft Skills:

• Ability to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each product

Physical Requirements and Work Environment:

• Extended periods of sitting at a computer and use of hands/fingers across keyboard or mouse

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 https://uhg.hr/transitioning-military

Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible. https://uhg.hr/vet

Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we’re presented with an opportunity to make a difference on a scale we couldn’t imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you’ll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You’ll help write the next chapter in the history of healthcare. And you’ll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is 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.

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