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Associate Recovery Resolutions Representative - Lawrenceville, IL

UnitedHealth Group Lawrenceville, IL Full-Time
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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 investigating, recovering and resolving all types of claims as well as recovery and resolution for health plans, commercial customers and government entities. May include initiating telephone calls to members, providers and other insurance companies to gather coordination of benefits data. Investigate and pursue recoveries and payables on subrogation claims and file management. Process recovery on claims. Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance. May conduct contestable investigations to review medical history. May monitor large claims including transplant cases.

Primary Responsibilities:

  • Setting up files for investigation (use of multiple systems to pull information, Adobe Pro to create internal files, Word/Excel, etc.).
  • Requesting medical records from providers (in writing/phone and/or fax)
  • Use internal and external resources (i.e., the internet) to locate provider fax/phone numbers.
  • Calling and speaking to providers about the status of medical record requests.
  • Manage file follow-up dates with multiple due dates.
  • Ability to work in a dynamic environment, both independently and in a group setting
  • Ability to review Healthcare claims to determine type of provider, identify patient, ICD-10/CPT codes, etc.

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)
  • Intermediate proficiency with computer, Windows PC applications, numeric 10 - key / keyboarding experience with the ability to navigate and learn new and complex computer systems.
  • 1+ year of experience in an Office setting environment using the telephone and computer as the primary instruments to perform job duties
  • 1+ years of Microsoft Office experience (ability to create, edit, copy, send and save documents and spreadsheets in Microsoft Word and Microsoft Excel)
  • 1+ years of experience with Adobe PDF files (combining documents into PDF format)
  • Ability to work an 8 hr shifts between 6:30 - 5:00 

Preferred Qualifications:

  • Healthcare experience with a focus on administrative tasks
  • Basic understanding of Healthcare claims including ICD - 10 and CPT codes
  • 1+ years of experience working with Medical claims
  • Customer service telephone experience
  • 1+ years working in production - based environment

Soft Skills:

  • Professional communication skills, both written and verbal
  • Must be well organized and able to multi – task (including managing file caseloads with various due dates and follow-up dates
  • Ability to work well with a team and maintain a positive attitude
  • Adaptable to rapidly changing work environment
  • Ability to be flexible and open to new ideas

Physical and Work Environment:

  • Ability to work in a dynamic environment, both independently and in a group setting
  • Prolonged periods of sitting at desk/computer using hands/fingers across keyboard or mouse

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.


Keywords: UHG, Medical, Lawrenceville, IL, Healthcare


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Job ID: 2551_854157


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