Senior Claims Representative - South Portland, ME

Company: UnitedHealth Group ( Learn More )

General Information
US-ME-South Portland
N/A
Not Specified
Full-Time
Not Specified
Not Specified
False
False
Job Description Position 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.(sm)

Individuals in this position are responsible for managing a caseload of initial liability and ongoing Financial Protection claims.  They will effectively and professionally utilize sound judgment, technical knowledge, communication skills, and focused resources (medical, vocational, legal, etc.) to manage claims to appropriate conclusion in accordance with applicable internal and external regulations, policies and procedures. 

Primary Responsibilities:
  • Provide expertise or general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims.
  • Authorize appropriate payment or refer claims to investigators for further review
  • Analyze and identify trends and provides reports as necessary
  • Consistently meet established productivity, schedule adherence, and quality standards
  • Provide excellent customer service
  • One or more years of experience with disability claims preferred but not required

  • Requirements:
  • High school Diploma / GED
  • Experience in using Excel create and maintain spreadsheets
  • 1+ years of customer service experience in solving customer problems in an office setting environment.
  • Experience in using MS word to create letters
  • Assets:
  • Bachelor's Degree (or higher)
  • 1+ years of experience in disability claims experience.

  • Soft Skills:
  • Work in a fast - paced environment.
  • Ability to multi - task, this includes ability to understand multiple products and multiple levels of benefits within each product
  • Physical Requirements and Work Environment:
  • Extended periods of sitting at a computer and use of hands / fingers across keyboard or mouse
  • Office environment
  • Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 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 where ever 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

    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 processing, claims processor; UnitedHealth Group, UnitedHealth care
    Job Requirements