Quality Assurance Analyst

This position is Remote in Central, Mountain, or Pacific Time Zones. You will have the flexibility to work remotely* as you take on some tough challenges.

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together.

The Quality Assurance Analyst primary responsibilities are to conduct reviews during the Itemized Bill Review active claim process and provide feedback to reduce errors and improve processes and performance.

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 6:30 am - 3:30 pm MST. It may be necessary, given the business need, to work occasional overtime.

We offer weeks of on-the-job training. The hours of the training will be aligned with your schedule.

Primary Responsibilities:

• Validate / analyze claim data for accuracy utilizing job aids, claim documents, policies, and procedures
• Deliver / communicate fact-based quality review determinations in objective, non-confrontational manner
• Provide supporting documentation for audit findings
• Maintain tracking/reporting of daily tasks
• Achieve production and quality goals/metrics
• Identify / communicate uncommon patterns / trends to Team Lead / Manager

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
• Must be 18 years of age OR older
• 3+ years of healthcare industry experience working with appeals and/or medical claims
• 2+ years of remote/work from home experience
• Experience with computers and Windows PC applications, which includes the ability to learn new and complex computer system applications
• Experience with Microsoft Excel (data entry, sort / filter, and work within tables) and Microsoft Outlook (email and calendar management)
• Ability to work between the hours of 6:30 am - 3:30 pm MST from Monday - Friday including the flexibility to work occasional overtime based on business need

Preferred Qualifications:

• 3+ years of medical claims and / OR auditing experience
• RemProduct / process knowledge
• System / application knowledge

Telecommuting Requirements:

• Reside within Mountain, Pacific, or Central Time Zone
• 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 including financial information
• Organizational and analytical skills
• Flexible and adaptable to a growing and changing environment
• Team player
• Ability to manage delicate matters with diplomacy

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $23.89 - $42.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.