Post Audit Coordinator

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.

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together.

Do you have experience building relationships with providers? Experience working in Fraud, Waste, Abuse, & Error? Are you a hotshot Microsoft Excel user? Want to work with an elite team of some of the brightest and most inventive people in the healthcare & technology industries? Optum is a health services business, part of the UnitedHealth Group family of companies, dedicated to making the health system work better for everyone. We serve people throughout the entire health system. Our team enjoys conversation-changing, life-changing, world-changing opportunities throughout their careers. Join us and see what it's like to do your life's best work.

The Post Audit Program Coordinator is the central point-of-contact for providers after an audit occurs. Sending Audit and Appeal Determination letters, assessing value of claims, and conducting provider follow ups to obtain a signoff. This position supports the review of suspected waste & abuse of health insurance claims.

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 8am - 5pm EST. It may be necessary, given the business need, to work occasional overtime.

We offer 4 weeks of on-the-job training. The hours of training will be aligned with your schedule.

Primary Responsibilities:

• Respond to provider inquiries via the call agent line and by email, addressing questions and concerns related to claims with professionalism, accuracy, and prompt follow-up
• Research and investigate claim statuses by reviewing documentation, system records, and applicable guidelines before providing clear and concise responses
• Acts as the central point-of-contact for specific hospital and health systems
• Plays a pivotal role in building relationships and influencing providers to obtain signoff on audits
• Accountable for day-to-day tasks associated with claims, including sending audit findings and appeal determination responses and following up with providers
• Assist in obtaining and triaging provider appeals to the appropriate team for processing
• Ensure adherence to federal compliance policies, contract compliance
• Analyze and create necessary spreadsheets of data

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
• Must be 18 years of age or older
• 2+ years of healthcare customer service experience
• Intermediate experience with MS Word & MS Excel
• Ability to work 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 8am - 5pm EST. It may be necessary, given the business need, to work occasional overtime

Preferred Qualifications:

• 2+ years of health insurance experience
• MS Excel Pivot table experience
• Knowledge of FWAE or Payment Integrity
• Adaptability and savvy in navigating a large, matrixed organization

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 written, verbal, analytical, organizational, time management, and problem-solving skills
• Strong interpersonal skills with ability to quickly build relationships
• Ability to adapt in a dynamic and high-growth environment
• Self-motivated with the ability to work independently

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

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). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $23.89 - $42.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

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.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.