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UnitedHealth Group Provider Reimbursement Coordinator - Telecommuter in Wausau, Wisconsin

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 UHC Team Repricer is responsible for identifying applicable UHC provider network contracts; applying UHC provider network contracted rates and reimbursement policies accurately and efficiently to medical claims for UMR.

You'll enjoy the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • UHC Team Repricers ensure network contracts and reimbursement policies and procedures are priced accurately on affiliated medical claims

  • Recommend system changes on provider contracts that appear inaccurate in the NDB (UHC Provider Network Database)

  • Be able to assist with UHC projects and other tasks related to provider repricing, as necessary and / or requested

  • Prioritize and organize own work to meet agreed upon deadlines

  • Manage inventory to ensure claims are repriced accurately and meet required turnaround time

  • Reprice claims fetched in Willow using the Willow Macro as well as process using Wrench, CUS and Call Trak applications

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)

  • 1+ year of CPS system processes / UHSS support area experience or equivalent education / experience in Medical, Insurance or Health Systems

  • Ability to utilize Microsoft Word (create / edit documents) and Microsoft Excel (create / edit spreadsheets)

  • Ability to successfully navigate computer systems and software

  • Ability to read directions and apply mathematical calculations to reprice claims

Preferred Qualifications

  • 1+ years of previous Healthcare experience

  • Exposure to iCES, NDB, ppoONE or network contracts

Soft Skills

  • Strong research and analytical skills

  • Strong written, verbal and business communication skills

  • Strong interpersonal skills at both an individual and team level

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that’s second to none. This is no small opportunity. It's where you can do your life's best work.(sm)

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

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: medical, insurance, health systems, medical review, repricing, research, analytical, #RPO