Claims Associate - International Falls, MN

UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.



SCS Shared Services, a member of the UnitedHealth Group family of companies, is a portfolio of businesses that offer unique and specialized health and wellness benefits, services and resources. If you're looking for a healthy change, consider joining our team today!

 

Responsibilities:
Accurate processing and completion of vision claims upon first receipt.
Process basic types of vision claims within current turnaround standards. 
Process basic correspondence (e.g., student status, employment updates).
Proficiency in product lines instructed in classroom training.
Ability to process complex claims which includes:
UHG product knowledge including standard plan components (benefits) applicable to the service center.
Office Specific Product knowledge including plan components (benefits). 
Standard Claim Processing, Policy, Procedures, Processes knowledge and Claim Processing policy / procedure / process reference material/resources knowledge.
Process to completion co - pay claims.
Process to completion claims with eligibility discrepancies.
Process to completion claims with coding discrepancies (codes).
Process to completion claims requiring internal/national routing.
Special projects as required.
Adhere to quality improvement initiatives.
Access Lotus Notes for incoming mail and respond to inquiries.



Requirements:
High school diploma or equivalency.
PC skills (Word / Excel).
Attention to detail.
Quality focused.
Decision making skills.
Organizational skills.
Problem solving.
Team player.

Diversity creates a healthier atmosphere:  equal opportunity employer M/F/D/V