Job Responsibilities : Claims Adjuster – Remote
Salary : $18 per hour
Company : UnitedHealthcare
Location : Remote US
Educational requirements : High School
- Review and research incoming claims by navigating multiple computer systems and platforms and accurately capturing the data / information necessary for processing (e.g. verify pricing prior authorizations applicable benefits)
- Ensure that the proper benefits are applied to each claim by using the appropriate processes and procedures (e.g. claims processing policies and procedures grievance procedures benefit plan documents.)
- Complete daily all data entry required to document and communicate the status of claims as needed adhering to all reporting requirements.
- Communicate and collaborate with members and providers to resolve claims errors/issues using clear simple language to ensure understanding.
- Learn and leverages new systems and training resources to help apply claims processes / procedures appropriately (e.g. on – line training classes coaches / mentors)
- High School Diploma / GED (or higher)
- 1+ years Customer Service Representative (CSR) experience or 1+ years experience in an office setting call center setting or phone support role
- Familiarity with computer and Windows PC applications which includes the ability to learn new and complex computer system applications
- Previous experience with medical claims processing preferred
- Familiar with small group or self – funded product designs
- Understanding of UHOPS processing system