Tier 3 Claims Representative - Remote

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

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. SM

Take on this role with UnitedHealth Group and you'll be part of a team that's reshaping how health care works for millions. Now, you can take advantage of some of the best resources and tools in the world to help serve our members. You'll play a lead role in a high volume, focused and performance driven call center where the goal is to always provide expertise and customer service support to members. This is no small opportunity. This is where you can bring your compassion for others while building your career.

This position is full-time (40 hours/week) Monday to Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00am - 7:00pm local time zone. It may be necessary, given the business need, to work occasional overtime.

We offer 13 weeks of paid training. The hours during training will be 7:00am to 3:30pm CST, Monday to Friday. Training will be conducted virtually from your home.

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Primary Responsibilities:

• Research claims in relation to Member Contract terms and request for service
• Reach out to Member to provide timely and accurate answers via Outbound calls only. This position does not take Inbound calls unless at your request for member to contact you
• Works independently
• Mentor others
• Meets expected turnaround ties for each assigned case
• Acts as a resource for others

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 working in Government Operations Medicare & Retirement within the last two years
• 1+ years of experience in Claims Processing OR 1+ years of experience in a Call center Customer Service Position
• Experience with computers and Windows PC applications, which includes the ability to learn new and complex computer system applications

Preferred Qualifications:

• 2+ years of experience in Claims Processing Healthcare Claims as a Tier 1 and / or Tier 2 level Claims Representative
• 1+ years of experience using COSMOS Claims Processing OR 1+ years of Claims Adjustments experience
• 1+ years of experience using Maestro
• Ability to set up a meeting in Microsoft Outlook and respond to emails and add attachments
• Ability to navigate through an Microsoft Excel spreadsheet and sort and filter

Soft Skills:

• Ability to work both as a team member in a situation that requires coordination of multiple functions but also enjoy working independently without intense supervision
• Ability to work from home and meet high level of productivity processing claims with a high level of complexity
• Excellent Communication Skills in both Oral and written format

Telecommuting Requirements:

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

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at

Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible.

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 10 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near - obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, Military families and Veterans wherever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work. SM

Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $17.12 - $30.34. The salary range for Connecticut / Nevada residents is $18.80 - $33.41. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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

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.

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