Logo of Huzzle

Home

Matches

Explore

Manage

Recovery and Resolution Analyst - National Remote

image

Optum

28d ago

  • Job
    Full-time
    Junior Level
  • Legal
    Healthcare
  • Dallas
    Remote

AI generated summary

  • You need a high school diploma, 2+ years in claims or collections, subrogation knowledge, MS Office skills, and strong communication. Must work full-time remotely with internet access.
  • You will investigate healthcare subrogation cases, negotiate recoveries, analyze data, communicate with stakeholders, document activities, ensure compliance, and mentor team members.

Requirements

  • High School Diploma / GED
  • Must be 18 years of age OR older
  • An understanding of subrogation principles, health insurance and / OR P&C insurance experience
  • Proficiency in Microsoft Office Suite of products
  • Ability to work between the hours of 8:00 am - 5:00 pm from Monday - Friday including the flexibility to work occasional overtime based on business need
  • 2+ years of claims OR collections experience
  • Knowledge of local, state and federal laws and regulations pertaining to insurance
  • Negotiation experience, specifically in the capacity of persuading and influencing others; ability to negotiate fair settlements consistent with the prevailing subrogation law
  • 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
  • Candidate must be highly organized with effective and exceptional verbal and written communication skills
  • Analytical, problem solving and decision-making skills required; ability to exercise good judgment
  • Ability to prioritize work, handle multiple tasks and work independently
  • Telephone and customer service skills; ability to interact professionally in challenging situations
  • Open to change and new information; ability to adapt behavior and work methods to changing organization and integrate best practices into the subrogation recovery process
  • All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Responsibilities

  • Investigate, evaluate, and negotiate healthcare subrogation matters for a multi-million dollar portfolio up to $20M (70%)
  • Comprehend the nuances of Medicare, Medicaid, Self-Funded ERISA and Non-ERISA related health insurance subrogation recoveries and reimbursements to analyze and move cases to recovery for the clients, including the negotiation of dollars that will be returned to the plan
  • Research applicability of laws, regulations and other requirements to cases, contracts or decisions
  • Analyze data and interpret legal research to make conclusions. Present results of analysis in writing and/or verbally to supports the Plan’s rights
  • Maintain working knowledge of ERISA and ensure adherence to state and federal subrogation laws
  • Utilize your understanding of and expertise of coverage, policy interpretation, contract interpretation, case law, state/federal regulations Identify, monitor and evaluate data to determine third party liability and reimbursement amounts; ongoing analysis of medical treatment to evaluate relatedness
  • Conduct a high volume of outbound calls and send out or respond to electronic, written and verbal inquiries to/ from attorneys, insurance companies and health plan members (20%)
  • Communicate effectively with various parties using all forms of correspondence throughout the subrogation recovery process. The analyst will correspond with plaintiff’s attorney, defense counsel, third party insurers, and all other parties of interest
  • Validate claim liability, adjuster's contact information, claim status, availability of coverage, accident-related injuries and health plan members' treatment status
  • Thoroughly document all written and verbal communications and maintain case activity calendar diaries (10%)
  • Ensure compliance with Health Insurance Portability and Accountability Act
  • May be involved with litigation as necessary
  • Must be able to act independent of an attorney, present the client’s case and negotiate a settlement with an adverse party with professionalism, integrity and vigor
  • Recommend and participate in round table discussions of complex cases to determine the best strategic solutions
  • Act as coach and mentor to other team members in the development of their subrogation technical skills
  • Assist management on special projects and any other assigned tasks

FAQs

Do we support remote work?

Yes, this position is fully remote, allowing you to telecommute from anywhere within the U.S.

What are the primary responsibilities of the Recovery and Resolution Analyst?

The primary responsibilities include investigating, evaluating, and negotiating healthcare subrogation matters, researching applicable laws and regulations, communicating effectively with various parties, and documenting all case activities.

What qualifications are required for this position?

The required qualifications include a High School Diploma or GED, an understanding of subrogation principles or health insurance, and proficiency in Microsoft Office Suite.

Are there preferred qualifications for candidates applying for this role?

Yes, preferred qualifications include 2+ years of claims or collections experience, knowledge of local, state, and federal insurance laws, and negotiation experience.

What is the work schedule for this position?

This is a full-time position with the work schedule being Monday to Friday from 8:00 am to 5:00 pm, with flexibility to work occasional overtime based on business needs.

Is training provided for this role?

Yes, we offer 4 weeks of paid training during normal business hours.

What skills are necessary for success in the Recovery and Resolution Analyst role?

Necessary skills include strong verbal and written communication, analytical and problem-solving abilities, organizational skills, and the ability to prioritize work and handle multiple tasks independently.

What is the salary range for this position?

The hourly range for this role is $23.70 to $46.35 per hour, based on factors such as local labor markets, education, and work experience.

Are there benefits associated with this position?

Yes, a comprehensive benefits package is offered, which includes incentive programs, equity stock purchase options, and a 401k contribution, all subject to eligibility requirements.

Does this position require any specific software proficiency?

Yes, proficiency in Microsoft Office Suite is required for this role.

What is the company's stance on diversity and inclusion?

UnitedHealth Group is committed to diversity and inclusion, believing that everyone deserves the opportunity to live their healthiest life, and actively works to address health disparities.

Is a drug test required before employment?

Yes, candidates are required to pass a drug test before beginning employment.

image

Optum

Science & Healthcare
Industry
10,001+
Employees

Mission & Purpose

Optum is a health services and technology company that provides a wide range of solutions to improve healthcare delivery and outcomes. They offer services in healthcare management, data analytics, pharmacy benefit management, and technology solutions to healthcare providers, payers, employers, and government agencies. Optum's ultimate mission is to improve the health system's efficiency and effectiveness, creating a healthier world for everyone. Their purpose lies in collaborating with healthcare partners to address complex challenges, such as improving care coordination, reducing healthcare costs, and enhancing patient experiences. By leveraging data-driven insights and innovative technology, Optum aims to empower healthcare professionals and organisations to deliver high-quality, patient-centered care and drive positive healthcare outcomes for individuals and communities worldwide.

Culture & Values

  • Integrity

    Honour commitments. Never compromise ethics.

  • Compassion

    Walk in the shoes of people we serve and those with whom we work.

  • Relationships

    Build trust through collaboration.

  • Innovation

    Invent the future, learn from the past.

  • Performance

    Demonstrate excellence in everything we do.