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  • Wausau, WI

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Claims Clerk - Wausau, WI

UnitedHealth Group • Wausau, WI

Posted 13 days ago

Job Snapshot

Full-Time
Healthcare - Health Services
General Business, Health Care
6

Applicants

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Job Description



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




Positions in this function are
responsible for providing expertise or general claims support to teams in
reviewing, researching, investigating, negotiating, processing and adjusting
claims. Authorizes the appropriate payment or refers claims to investigators
for further review. Conducts data entry and re-work; analyzes and identifies
trends and provides reports as necessary.





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





Primary Responsibilities:




  • auto;mso-list:l0 level1 lfo1;tab-stops:list .5in;background:white">Provide general claims support by reviewing,
    researching, investigating, negotiating, processing and adjusting
    claims. 

  • auto;mso-list:l0 level1 lfo1;tab-stops:list .5in;background:white">Authorize the appropriate payment or refers claims to
    investigators for further review.

  • auto;mso-list:l0 level1 lfo1;tab-stops:list .5in;background:white">Conduct data entry and re-work; analyzes and identifies
    trends and provides reports as necessary.

  • auto;mso-list:l0 level1 lfo1;tab-stops:list .5in;background:white">Consistently meet established productivity, schedule
    adherence, and quality standards

  • auto;mso-list:l0 level1 lfo1;tab-stops:list .5in;background:white">Recognize claims by determining claim type - HCFA,
    Hospital, UB, and/or RX

  • auto;mso-list:l0 level1 lfo1;tab-stops:list .5in;background:white">Identify more complicated claims and refer them to
    Senior Claim Processor or Supervisor

  • auto;mso-list:l0 level1 lfo1;tab-stops:list .5in;background:white">Calculate other insurance and re-pricing benefits

  • auto;mso-list:l0 level1 lfo1;tab-stops:list .5in;background:white">Work claims files to ensure the appropriate eligibility
    and provider records are matched to the claim

  • auto;mso-list:l0 level1 lfo1;tab-stops:list .5in;background:white">Updates and maintains claims tracking database

  • auto;mso-list:l0 level1 lfo1;tab-stops:list .5in;background:white">Will use numeric 10 key pad and Microsoft Excel



Required Qualifications:


  • High School Diploma / GED or higher

  • 1+ year of experience in an Office setting environment
    using the telephone and computer as the primary instruments to perform job
    duties

  • Basic proficiency with computer, Windows PC
    applications, and numeric 10 key, which includes the ability to learn new
    and complex computer system applications

Preferred Qualifications:


  • 2+ years Data Entry experience

  • Basic understanding of Healthcare claims including
    ICD-9 and CPT codes

  • 1+ years of experience working with Medical claims

  • Ability to create, copy, edit, send, and save within Word, Excel, and Outlook

  • 1+ year working in production based environment

  • Type 60+ words per minute

Physical Requirements and Work
Environment:


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

  • Office environment

Soft Skills:









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

    Take the next step, online at: www.yourlifesbestwork.com

    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 health care. 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.


    Keywords: Wausau, WI, Claims Clerk, data entry, medical claims, Word, Excel, Outlook, production,

    Job ID: 2551_768418
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