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Job Details

COB Claims Representative - Green Bay WI

Location
Green Bay, WI, United States

Posted on
Oct 11,2019

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Job Description:
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.
As a COB Claims Representative
, you'll play a critical role in creating a quality experience that impacts the financial well - being of our members. You will be the expert problem solver as you work to quickly identify, analyze and resolve issues in a fast paced environment. This is your chance to take your career to the next level as you support teams by reviewing, investigating, and processing claims. Bring your listening skills, emotional strength and attention to detail as you work to ensure every claim has a fair and thorough review.
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 6:30am - 5pm. It may be necessary, given the business need, to work occasional overtime or weekends. Our office is located at 3100 AMS Blvd, Green Bay, WI 54313.
Primary Responsibilities:
Initiate telephone calls to members, providers and other insurance companies to gather coordination of benefits data
Verify / validate applicable systems to reflect updated COB information and ensure that future payments are processed correctly
Ensure that the proper benefits are applied to each claim by using the appropriate processes and procedures (e.g. claims processing policies and procedures, grievance procedures, CMS / Medicare guidelines, benefit plan documents
Complete on a daily basis all data entry required to document and communicate the status of claims as needed adhering to all reporting requirements
Communicate and collaborate with members and providers to resolve claims errors/issues, using clear, simple language to ensure understanding
Learn and leverages new systems and training resources to help apply claims processes / procedures appropriately (e.g. on - line training classes, coaches / mentors)
Meet the performance goals established for the position in the areas of: efficiency, accuracy, quality, member satisfaction and attendance
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)
1 years of experience in a related environment (i.e. office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools
Experience with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
Preferred Qualifications:
Experience with UHOPS processing system
Previous experience with medical claims processing preferred
Experience with small group or self - funded product designs
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 health care. 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: medical claims, healthcare claims, claims representative, claims rep, claims processing, claims processor; UnitedHealth Group, UnitedHealth care, training class
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Verify / validate applicable systems to reflect updated COB information and ensure that future payments are processed correctly
Ensure that the proper benefits are applied to each claim by using the appropriate processes and procedures (e.g. claims processing policies and procedures, grievance procedures, CMS / Medicare guidelines, benefit plan documents
Complete on a daily basis all data entry required to document and communicate the status of claims as needed adhering to all reporting requirements
Communicate and collaborate with members and providers to resolve claims errors/issues, using clear, simple language to ensure understanding
Learn and leverages new systems and training resources to help apply claims processes / procedures appropriately (e.g. on - line training classes, coaches / mentors)
Meet the performance goals established for the position in the areas of: efficiency, accuracy, quality, member satisfaction and attendance
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)
1 years of experience in a related environment (i.e. office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools
Experience with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
Preferred Qualifications:
Experience with UHOPS processing system
Previous experience with medical claims processing preferred
Experience with small group or self - funded product designs
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 health care. 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: medical claims, healthcare claims, claims representative, claims rep, claims processing, claims processor; UnitedHealth Group, UnitedHealth care, training class
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