UnitedHealth Group is hiring

Provider Liaison Specialist - Telecommute job at UnitedHealth Group, San Diego

This job is expired

Find similar jobs

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

As a Provider Liaison Specialist, you will be providing a critical function to a new business built from the ground up. In this role, you will support the daily activities of the business, including claims research and case preparation for Provider Liaison efforts. This position requires a motivated self-starter with a blend of provider network experience, process knowledge, and strong communication skills.

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

Primary Responsibilities:

  • Research claims, reviews Out-of-Network (OON) payment history, reconciles medical bills and related documentation, and summarizes information to develop data-driven and issue-specific negotiation strategies to reduce medical bills
  • Research and provide insight into billing practices of the healthcare provider to Provider Liaison or Sr. Provider Liaison
  • Triage questions from Provider Liaisons and/or Advisors and provide additional information to inform cases (i.e., perform research of unique payments related to a patient’s bill, etc.)
  • Serve as a claims Subject Matter Expert (SME) and assist in developing Provider Liaison strategy for all case escalations from Advisors and/or Provider Liaison/Sr. Provider Liaison team members
  • Monitor and identify all cases for high dollar negotiation opportunities and/or Providers of Interest (POI)
  • In coordination with the Manager, produce case studies (i.e., background, Provider Liaison path, resolution of interesting/complex) for executive presentations
  • Performs other duties as assigned

May Be Called Upon To:

  • Engages directly with healthcare providers or their delegates to negotiate reimbursement amounts on behalf of the consumers referred to Naviguard
  • Closely tracks and documents each negotiation, providing timely follow-up and issue closure with providers and consumers

Daily Practices:

  • Ability to listen skillfully, build rapport, and communicate effectively
  • Uses pertinent data and facts to identify and solve a range of problems within area of expertise
  • Investigates non-standard requests and problems, with some assistance from others
  • Works exclusively within a specific knowledge area
  • Prioritizes and organizes own work to meet deadlines
  • Provides explanations and information to others on topics within area of expertise
  • Stays current with all systems communications (i.e., chatters, email, etc.)
  • Remains current on all relevant trainings and operational updates

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:

  • Undergraduate degree or equivalent experience
  • 2+ years working with a healthcare organization, provider and/or billing office, or similar industry in a role equivalent to network/contract management, revenue cycle, provider services, etc.
  • Proficiency with Windows PC applications; Word, Excel, Outlook and PowerPoint with the ability to navigate and learn new and complex computer system applications

Preferred Qualifications:

  • 2+ years of experience working with providers and provider offices, preferably in contract review and management and/or healthcare billing
  • Knowledge of UHC-specific systems, such as the Network Database (NDB)
  • Knowledge of medical billing and coding, claims processing systems, and related guidelines

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

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)

Colorado, Connecticut or Nevada Residents Only: The hourly range for Colorado residents is $26.15 to $46.63. The hourly range for Connecticut / Nevada residents is $28.85 to $51.30. 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.

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

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.

Job country: United States

City: San Diego

Category: Business Operations Specialists, All Other

Location: San Diego, CA, United States

Job posted 2022-06-04

This job is expired

Find similar jobs