Reclamation Team Lead
Optum is a part of UnitedHealth Group, dedicated to improving health data flow and creating a connected healthcare system. The Reclamation Team Lead will oversee a team focused on investigating and resolving claims to reduce medical costs, ensuring compliance and optimizing processes.
Responsibilities
- Examine, assess, and document business operations and procedures to ensure data integrity, data security and process optimization
- Investigate, recover, and resolve all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities
- Investigate and pursue recoveries and payables on subrogation claims and file management
- Initiate phone calls to other insurance companies to gather coordination of benefits information
- Process recovery on claims
- Ensure adherence to state and federal compliance policies, reimbursement policies, and contract compliance
- Use pertinent data and facts to identify and solve a range of problems within area of expertise
Skills
- High School Diploma / GED or equivalent work experience
- Must be 18 years or older
- 1+ years of experience analyzing data and identifying cost saving opportunities OR relevant college courses including economics, statistics, data science, or finance
- Experience in healthcare industry
- Knowledge of claims processing systems and guidelines/processes
- Knowledge of X12 EDI transactions
- Intermediate skills with Microsoft Excel (create, edit, sort, filter, pivot tables)
- Ability to work in the office 3-4 times a week
- Ability to work any of our 8-hour shift schedules during our normal business hours 8:00am - 6:00pm. It may be necessary, given the business need, to work occasional overtime
- 2+ years of experience with claims auditing and researching claims information
- Knowledge of Medicaid/Medicare/Commercial Reimbursement methodologies
Benefits
- Comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase
- 401k contribution
Company Overview
Company H1B Sponsorship