Claims Adjustment Representative - Remote in NY

Remote, USA Full-time Posted 2025-02-22

If you are located within the State of New York, you will have the flexibility to telecommute* (work from home) as you take on some tough challenges.

At UnitedHealthcare, we?re simplifying the health care experience, creating healthier communities, and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system... of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us and start doing your life?s best work.SM

This position is full time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 5:00pm. It may be necessary, given the business need, to work occasional overtime or weekends.

We offer 4 - 6 weeks of paid training. The hours during training will be 8:00am to 4:30pm EST, Monday - Friday. Training will be conducted virtually from your home.
? All Telecommuters will be required to adhere to UnitedHealth Group?s Telecommuter Policy.

Primary Responsibilities
? Review and research more complicated claims by navigating multiple computer systems and platforms
? Capture accurately pricing, prior authorizations, applicable benefits, coding, and other information
? Update claim information based on research and communication from member or provider
? Complete necessary adjustments to claims and ensures the proper benefits are applied to each claim
? Communicate extensively with members and providers electronically regarding adjustments to resolve claims errors/issues, using clear, simple language to ensure understanding

This is a challenging role with serious impact. You?ll be providing a senior level of support and subject matter expertise within a fast paced, intense and high-volume claims operation where accuracy and quality are essential.

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 equivalent work experience
? Must be 18 years of age OR older
? 1+ years of Experience with UNET claims
? Experience with Microsoft Word (creating / updating documents / letters, and letter formatting) and Microsoft Outlook (creating / sending emails, and calendar invites)
? Working knowledge with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications (including comfort using shortcuts and demands)
? Ability to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 5:00pm. It may be necessary, given the business need, to work occasional overtime or weekends

Telecommuting Requirements
? Reside within the State of New York
? Ability to keep all company sensitive documents secure (if applicable)
? Required to have a dedicated work area established that is separated from other living areas and provides information privacy
? Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

Soft Skills
? Attention to detail
? Excellent written communication skills
? Ability to remain focused and productive each day though tasks may be repetitive
? Ability to multi - task, including the ability to understand multiple products and multiple levels of benefits within each product

New York Residents Only: The hourly range for this is $16.54 - $32.55 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you?ll find a far-reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes ? an enterprise priority reflected in our mission.

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.

#RPO

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