Provider Claims Liaison - NY Based (Remote) - Health Care Innovation and Patient Advocacy

Join the Movement to Revolutionize Health Care: Become a Provider Claims Liaison with UnitedHealth Group

Are you a motivated and experienced professional in the health care industry, looking for a new challenge that will allow you to make a real difference in people's lives? Do you have a passion for patient advocacy and a knack for resolving complex issues? If so, we invite you to join UnitedHealth Group as a Provider Claims Liaison, working remotely from New York State.

About UnitedHealth Group

At UnitedHealth Group, we're committed to helping people live healthier lives and making the health system work better for everyone. We believe that everyone deserves the opportunity to live their healthiest life, and we're dedicated to mitigating our impact on the environment and delivering equitable care that addresses health disparities and improves health outcomes.

As a leading health care company, we're constantly innovating and improving our services to meet the evolving needs of our customers. Our mission is to provide integrated health programs across the entire continuum of care, and we're looking for talented professionals like you to join our team.

Job Summary

As a Provider Claims Liaison, you will play a critical role in educating contracted providers and internal staff on NY Medicaid billing requirements and methodologies. You'll serve as a point of contact for centralized service units, resolve complex service issues, and facilitate management of claims and service issues in conjunction with the Market Lead. If you're a motivated and experienced professional with excellent communication and analytical skills, we encourage you to apply for this exciting opportunity.

Key Responsibilities

• Provider Education: Educate contracted providers and internal Provider Relations and Network Claims Liaison staff on NY Medicaid billing requirements and methodologies, including claims submission requirements, coding updates, electronic claims transactions, and electronic fund transfer.
• Issue Resolution: Serve as a point of contact for centralized service units when local market information or action is required to resolve/manage service issues. Promptly escalate and initiate expedited resolution actions within the Service Model, and establish regular communication with providers until complete resolution is achieved.
• Service Management: Facilitate management of complex service and/or service issues in conjunction with the Market Lead, including analysis of service failures to determine course of action to resolve the service issue and ensure service process and/or performance gaps are documented and addressed.
• Reporting and Analysis: Collate, evaluate, and report on service issues/risks/trends to support Network Management contract negotiations and relationship management for core and strategic providers.
• Provider Satisfaction: Identify trends and guide the development and implementation of strategies to improve provider satisfaction. Frequently communicate with providers to assure the effective exchange of information and gain feedback regarding the extent to which providers are informed about appropriate claims submission practices.

Requirements and Qualifications

Essential Qualifications:

• Experience: 5+ years of experience in a managed health care environment working in or with the insurance side of the business.
• NY Medicaid Billing: 2+ years of experience with NY Medicaid billing and methodology.
• Provider Relations: Experience working with NY providers and claims and billing experience (examples of experience include: Claims processor, Claims auditor, Claims examiner, Certified Coder, etc.).
• Issue Resolution: Experience with provider relations issue resolution and conflict management skills.
• Performance Metrics: Proven ability to meet performance metrics (turn-around time, issue resolution, root cause analysis).
• Independent Work: Proven ability to work independently with minimum supervision.
• Communication Skills: Proven solid verbal and written communication skills.
• Location: Must reside in NY State.
• Travel: Ability to travel 25% of the time within NY State.

Preferred Qualifications:

• Certifications: Certification in a related field (e.g., coding, billing, health care management).
• Leadership Experience: Experience in a leadership or management role.

What We Offer

Compensation and Benefits:

The salary range for this role is $70,200 to $137,800 annually, depending on experience and qualifications. In addition to your salary, UnitedHealth Group offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution.

Career Growth and Development:

At UnitedHealth Group, we're committed to helping our employees grow and develop their careers. We offer:

• Training and Development: Ongoing training and development opportunities to help you build new skills and advance in your career.
• Career Advancement: Opportunities for career advancement and promotion within the company.
• Mentorship: Access to experienced mentors and coaches who can help guide you in your career.

Work Environment and Culture:

At UnitedHealth Group, we're proud of our culture and work environment. We offer:

• Remote Work: The opportunity to work remotely from NY State.
• Flexible Scheduling: Flexible scheduling and work arrangements to support work-life balance.
• Diverse and Inclusive: A diverse and inclusive work environment that values and respects all employees.

Why Join UnitedHealth Group?

At UnitedHealth Group, we're committed to making a positive impact on the lives of our customers and the communities we serve. By joining our team, you'll have the opportunity to:

• Make a Difference: Make a real difference in the lives of our customers and the communities we serve.
• Grow and Develop: Grow and develop your career in a dynamic and supportive work environment.
• Be Part of a Team: Be part of a diverse and inclusive team that values and respects all employees.

How to Apply

If you're a motivated and experienced professional looking for a new challenge, we encourage you to apply for this exciting opportunity. Please submit your application, including your resume and cover letter, to:

We look forward to hearing from you!