Senior Claims Business Process Analyst - Portland, Me
UnitedHealth Group (Southern/Portland, Maine)

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UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health. Ingenix delivers Intelligence for Health Care. A UnitedHealth Group company, Ingenix unites the brightest minds to transform organizations and improve health care through information and technology. We serve a diverse customer base within the health care community, including health care payers, providers, employers, pharmaceutical companies, consumers, workers’ compensation and auto liability insurers, and government agencies.   This position is involved in management and administration of automation of workers' compensation and auto liability fee schedules and guidelines for medical bill adjudication and for managing general operations of the rules team. - Coordinates, supervises and is accountable for the daily activities of business support and the production team. Primary Responsibilities: Handle incoming/outgoing calls, faxes, mail, and express deliveries from healthcare providers Monitor and manage call case load, ensuring expedient resolution and routing for all provider calls Compile documentation and review each for accuracy and completeness Data entry for all calls, documentation, certified stubs, and return mail Organize and maintain file system (on-line and/or off-line) for documentation, certified stubs and returned mail Participate with all aspects of letter mailings to include generating letters and labels, QA, posting and mailing Participate in all meetings and training sessions Create weekly analysis of call log Research returned mail Assists with special projects (copying records, file storage, sorting disorganized documentation…) Qualifications:2+ years experience and/or Associate degree in medical services required1 year experience working in a healthcare call center environment required1 year experience of medical billing and claims processing (including CPT and ICD-9) required2 years experience in Microsoft Office applications (Outlook, Word and Excel) as well as Internet use required6+ months working knowledge of HIPAA compliance/PHI requiredFamiliar with medical terminology Experience working within an office setting using skills such as filing and data entry highly preferredExtremely organized, flexible, detail oriented, positive and multitasking skills are required Experience with metered mail and postage requirements preferred but will train Ability to occasionally lift 25lbsAbility to work individually as well as collaboratively on multi-disciplinary teamsDiversity creates a healthier atmosphere: equal opportunity employer M/F/D/V.  UnitedHealth Group is a drug-free workplace.  Candidates are required to pass a drug test before beginning employment.