Senior Recovery / Resolution Analyst - Remote

UnitedHealth Group

Hartford Connecticut

United States

Information Technology
(No Timezone Provided)

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

Combine two of the fastest - growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making Healthcare data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work. SM

The Senior Recovery/Resolution Analyst will work with a team on researching issues to determine feasibility of reducing medical costs through prospective solutions of claim system processes and claim business rules.

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 (8:00am - 5:00pm). It may be necessary, given the business need, to work occasional overtime.

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

Primary Responsibilities:

  • Perform clinical review of facility claims vs. medical records to determine if the claim is supported or unsupported.
  • Maintain standards for productivity and accuracy.
  • Provide clear and concise clinical logic to the providers when necessary.
  • Attend and provide feedback during monthly meetings with assigned internal customer department.
  • Provide continuous feedback on how to improve the department relationships with internal team members and departments.
  • Keep up required Coding Certificate and Nursing Licensure.
  • Complete compliance hours as required by the department.

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 (or higher)
  • Working knowledge of medical terminology and claim coding.
  • Knowledge of claims processing systems and guidelines/processes
  • Intermediate skills with Microsoft Excel (create, edit, sort, filter, pivot tables)
  • Experience in healthcare
  • Certified Professional Coder (CPC)

Telecommute Requirements

  • Required to have a dedicated work area established that is separated from other living areas and provides information privacy
  • Ability to keep all company sensitive documents secure (if applicable)
  • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

Preferred Qualifications:

  • Associate's degree (or higher)
  • Coder Certification (CCS, CIC, COC, or CPMA)
  • Registered Nurse License
  • 1+ years project management experience
  • 2+ years of Medical record coding experience with experience in Evaluation and Management Services in the inpatient setting.
  • 1+ years of experience analyzing data and identify cost saving opportunities
  • Knowledge of Medicaid/Medicare Reimbursement methodologies
  • 2+ years of experience with claims auditing and researching claims information
  • Microsoft Access (create, edit, format, manipulate data) Intermediate skills with Microsoft Excel (create, edit, sort, filter, pivot tables)

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at

Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible.

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health - related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work. SM

Colorado Residents Only: The hourly range for Colorado residents is $25.63 $45.72. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

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: claims, data entry, coding, medical coding, customer service representative, customer service, CSR, UnitedHealth Group, Optum, OptumRx, call center, UnitedHealthcare, health care, healthcare, office, phone support, training class, advocate, work at home, work from home, WAH, WFH, remote, telecommute, hiring immediately, #rpo

Senior Recovery / Resolution Analyst - Remote

UnitedHealth Group

Hartford Connecticut

United States

Information Technology

(No Timezone Provided)

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

Combine two of the fastest - growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making Healthcare data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work. SM

The Senior Recovery/Resolution Analyst will work with a team on researching issues to determine feasibility of reducing medical costs through prospective solutions of claim system processes and claim business rules.

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 (8:00am - 5:00pm). It may be necessary, given the business need, to work occasional overtime.

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

Primary Responsibilities:

  • Perform clinical review of facility claims vs. medical records to determine if the claim is supported or unsupported.
  • Maintain standards for productivity and accuracy.
  • Provide clear and concise clinical logic to the providers when necessary.
  • Attend and provide feedback during monthly meetings with assigned internal customer department.
  • Provide continuous feedback on how to improve the department relationships with internal team members and departments.
  • Keep up required Coding Certificate and Nursing Licensure.
  • Complete compliance hours as required by the department.

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 (or higher)
  • Working knowledge of medical terminology and claim coding.
  • Knowledge of claims processing systems and guidelines/processes
  • Intermediate skills with Microsoft Excel (create, edit, sort, filter, pivot tables)
  • Experience in healthcare
  • Certified Professional Coder (CPC)

Telecommute Requirements

  • Required to have a dedicated work area established that is separated from other living areas and provides information privacy
  • Ability to keep all company sensitive documents secure (if applicable)
  • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

Preferred Qualifications:

  • Associate's degree (or higher)
  • Coder Certification (CCS, CIC, COC, or CPMA)
  • Registered Nurse License
  • 1+ years project management experience
  • 2+ years of Medical record coding experience with experience in Evaluation and Management Services in the inpatient setting.
  • 1+ years of experience analyzing data and identify cost saving opportunities
  • Knowledge of Medicaid/Medicare Reimbursement methodologies
  • 2+ years of experience with claims auditing and researching claims information
  • Microsoft Access (create, edit, format, manipulate data) Intermediate skills with Microsoft Excel (create, edit, sort, filter, pivot tables)

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at

Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible.

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health - related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work. SM

Colorado Residents Only: The hourly range for Colorado residents is $25.63 $45.72. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

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: claims, data entry, coding, medical coding, customer service representative, customer service, CSR, UnitedHealth Group, Optum, OptumRx, call center, UnitedHealthcare, health care, healthcare, office, phone support, training class, advocate, work at home, work from home, WAH, WFH, remote, telecommute, hiring immediately, #rpo