GEHA Associate Account Manager of Client Services – National Remote

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. 

Positions in this function serve as the liaison between the customer and the UMR departments for anything call/claim, and overall operational performance related. 

In this role you will identify and resolve operational problems. This includes the ability to use all resources and tools to complete thorough research and reach out to the appropriate department for assistance when necessary. You will also need to ensure the call and claim teams have the adequate resources to serve our customers, such as updating HPDB timely, providing customer specific training, and system support and guidance to an external business partner handling member services using UMR’s systems. The Operations Service Manager also maintains the customer’s medical plan installation documents and will test any benefit changes in CPS. Which may require you to consult with other departments i.e.  Account Management and Integration Support to ensure benefit intent is understood. This role is equally challenging and rewarding. You’ll assume the responsibility of servicing a complex, high profile, premier account customer while being part of UMR’s new, unique and exciting TPA model.

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

Primary Responsibilities:

• Works independently to manage own tasks and apply knowledge/skills to a range of complex activities
• Demonstrates great depth of knowledge/skills in own function and increased knowledge/skills in other functions such as coding, networks, integration, HRA, HCR regulations, etc.
• Proactively identifies non-standard requests and potential problems; investigates and solutions using defined processes, expertise and judgement.  Resolution is determined by use of knowledge, research, and internal contacts
• Identify potential claim and / or customer service issues and create a plan to ensure risk is minimized
• Consults with key business partners outside of the team to ensure benefit intent is understood based on source documents and output matches (coding, SAE, PNO, network services, integration support)
• Serve as the liaison to a complex premier account to manage first level response and resolution of escalated issues with external and internal customers, including a complex business partnership
• Identify and resolve operational problems using undefined processes, expertise and judgment
• Investigate claim and / or customer service issues as identified and communicate resolution to customers
• Responsible for maintaining customer’s medical plans installation documents
• Responsible for testing customer benefit changes in CPS
• Create and update HPDB’s
• Identify the need for and providing specific and remedial training to internal UMR staff as well as external business partner staff working in UMR’s ecosystem
• May act as a resource for others and coordinate other activities

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)
• 2+ years of experience in medical claim processing in CPS
• 2+ years of experience with medical billing (ICD-10 diagnoses, CPTs, and HCPCS codes) 
• 2+ years of experience with leading complex analytical projects including presenting findings to internal and/or external leadership level audience
• 2+ years of experience working with multiple internal teams or lines of business 
• Intermediate level of proficiency with MS Office (Excel, Outlook, Teams, Word, PPT)
• Ability to work any of our 8-hour shift schedules during our normal business hours of 7:00am – 5:00pm in your time zone. It may be necessary, given the business need, to work occasional overtime

Preferred Qualifications:

• Familiarity with claims
• Knowledge of OSM or GEHA
• Previous experience in a leadership or client-facing position
• Experience creating new processes and procedures to streamline a workflow within the organization
• Knowledge of medical claims billing (ICD-10 diagnoses, CPTs, and HCPCS codes)

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

For more information on our Internal Job Posting Policy, click here.

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 

 

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. 

 

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 

 

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

 

 

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. 

 

UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.

 

 

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