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Performs follow up actions including correcting payer rejections, checking claim status, updating patient registration related items, writing/processing appeals, performing corrected claims, and rebilling claims as necessary to ensure claims are processing in a timely fashion; escalate issues as appropriate to leadership. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.

HOUR

UnitedHealth Group is a health care and well-being company that’s dedicated to improving the health outcomes of millions worldwide. We are comprised of two distinct and complementary businesses, UnitedHealthcare and Optum, working to build a better health system for all. Here, your contributions matter as they will help transform health care for years to come. Make an impact with a diverse team that shares your passion for helping others.

What we do

Gain insights on how we work to help people live healthier lives and help make the health system work better for everyone by watching this video.

<a href="https://www.youtube.com/watch?v=5PbNyi2IDkY">https://www.youtube.com/watch?v=5PbNyi2IDkY</a> 

Caring. Connecting. Growing together. 

Being a part of UnitedHealth Group means working to improve health outcomes for everyone, including yourself. Here is how:

• Caring. Your total health and well-being are important to us. Whatever matters most to you — we have resources to help you be your best at work and at home. The benefits range from free Peloton courses to financial counseling. <a href="https://careers.unitedhealthgroup.com/culture/what-we-offer/">Learn more about what we offer.</a> 

• Connecting. We recognize our collective power to make an impact across our communities because we believe the health of any society is measured by the overall health of its people. <a href="https://careers.unitedhealthgroup.com/culture/">Learn more about our culture.</a> 

• Growing together. UnitedHealth Group is full of inspiring career stories, and we offer a lifetime of opportunities. <a href="https://careers.unitedhealthgroup.com/career-areas/">Discover all the ways you can learn, grow and develop.</a>

UnitedHealth Group Inc

Insurance Follow up Representative

Provides second-level reviews of clinical documentation of concurrent and retrospective documentation as it relates to Patient Safety Indicators (PSI), Hospital Acquired Conditions (HAC), payer denials, working DRG and final DRG mismatches, mortality reviews, and other appropriate second-levels. SUMMARY: Works with physicians, HIM (Health Information Management), Clinical Documentation Integrity (CDI) team members, ancillary staff, and multidisciplinary team members to improve the quality, and completeness of documentation of the patient's clinical condition and treatment provided for designated populations.

Tucson Medical Center

RN Clinical Documentation Integrity Second-Level Reviewer

This position is responsible for National Committee for Quality Assurance Healthcare Effectiveness Data and Information Set’s (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS®) initiatives, including leading all aspects of training, implementation and reporting of medical record retrieval, review (MRR) and overread. Leads MRR and related HEDIS compliance audit deliverables, Oversees and performs project management of assignments from beginning to end establishing timelines, coordinating, monitoring, troubleshooting, summarizing, and reporting on project deliverables.

Blue Cross Blue Shield of Arizona

Lead HEDIS Specialist - Hybrid

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This position is responsible for National Committee for Quality Assurance Healthcare Effectiveness Data and Information Set's (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS) initiatives, including leading all aspects of training, implementation and reporting of medical record retrieval, review (MRR) and overread. Leads MRR and related HEDIS compliance audit deliverables, Oversees and performs project management of assignments from beginning to end establishing timelines, coordinating, monitoring, troubleshooting, summarizing, and reporting on project deliverables.

At the Blue Cross and Blue Shield Association (BCBSA), we provide business strategy, technical support and consulting expertise to 36 Blue Cross and Blue Shield companies across the nation, employing more than 1,000 of the best strategic thinkers in the industry.  We are a Brand manager that sets quality control standards for the 36 independent companies that use the Blue Cross and Blue Shield Brands, and we serve as a trade association that represents these Blue companies. It is through our involvement that the Blues companies share a united vision and strategy while also benefiting from the local strength of all member companies.

Blue Cross and Blue Shield Association

Makes sure all initial consultations, pertinent notes, lab slips, radiology and pathology reports are available to the physician prior to patient arrival. Eye-hand coordination and manual dexterity sufficient to operate a computer keyboard, photocopier, fax machine, telephone, calculator, and other office equipment.

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