Claims Representative
UnitedHealthcare, Nutterville, WI, United States
Location
This position is onsite. Our office is located at 115 W WAUSAU Ave, Waushu, 54401.
About UMR UMR, UnitedHealth's third‑party administrator (TPA) solution, is the nation’s largest TPA. When you work with UMR, what you do matters. It's that simple and that rewarding.
We provide consumer‑oriented health benefit plans to millions of people; our goal is to create higher quality care, lower costs and greater access to health care. Join us and you will be empowered to achieve new levels of excellence and make a profound and personal impact as you contribute to new innovations in a vital and complex system. Opportunities are endless for your career development and advancement within UMR due to our record‑breaking growth.
Regardless of your role at UMR, the support you feel all around you will enable you to do what you do with energy, quality and confidence. So, take the first step in a fast‑paced, highly diversified career.
Position Details This position is full time (40 hours/week), Monday – Friday. Employees have the flexibility to work an 8‑hour shift schedule during normal business hours (7:00am‑8:00pm CST). Occasional overtime may be required.
Training is 9 weeks paid. Hours during training: 8:00am – 4:30pm CST, Monday – Friday. Training conducted onsite.
Primary Responsibilities
Provide expertise or general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims
Analyze and identify trends and provide reports as necessary
Consistently meet established productivity, schedule adherence and quality standards
This is a challenging role that takes an ability to thoroughly review, analyze and research complex health care claims in order to identify discrepancies, verify pricing, confirm prior authorizations and process them for payment. You'll need to be comfortable navigating across various computer systems to locate critical information. Attention to detail is critical to ensure accuracy, which will impact the timely processing of the member's claim.
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 equivalent work experience
Must be 18 years of age or older
Proficiency with Windows PC applications, including navigating multiple programs and learning new and complex computer system applications
Must be onsite at 115 W WAUSAU Ave, Waushu, 54401, and able to work full time at this location
Ability to work full time (40 hours/week), Monday – Friday, with flexibility for occasional overtime
Preferred Qualifications
1+ years of experience in a related environment (office, administrative, clerical, customer service, etc.) using phones and computers as primary job tools
1+ years of experience processing medical, dental, prescription or mental health claims
Compensation & Benefits Pay ranges from $17.98 to $32.12 an hour for full‑time employment, with compensation based on local labor markets, education, work experience and certifications. In addition to salary, we offer a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contributions (subject to eligibility). We comply with all minimum wage laws as applicable.
Equal Employment Opportunity UnitedHealth Group is an Equal Employment Opportunity employer. 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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About UMR UMR, UnitedHealth's third‑party administrator (TPA) solution, is the nation’s largest TPA. When you work with UMR, what you do matters. It's that simple and that rewarding.
We provide consumer‑oriented health benefit plans to millions of people; our goal is to create higher quality care, lower costs and greater access to health care. Join us and you will be empowered to achieve new levels of excellence and make a profound and personal impact as you contribute to new innovations in a vital and complex system. Opportunities are endless for your career development and advancement within UMR due to our record‑breaking growth.
Regardless of your role at UMR, the support you feel all around you will enable you to do what you do with energy, quality and confidence. So, take the first step in a fast‑paced, highly diversified career.
Position Details This position is full time (40 hours/week), Monday – Friday. Employees have the flexibility to work an 8‑hour shift schedule during normal business hours (7:00am‑8:00pm CST). Occasional overtime may be required.
Training is 9 weeks paid. Hours during training: 8:00am – 4:30pm CST, Monday – Friday. Training conducted onsite.
Primary Responsibilities
Provide expertise or general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims
Analyze and identify trends and provide reports as necessary
Consistently meet established productivity, schedule adherence and quality standards
This is a challenging role that takes an ability to thoroughly review, analyze and research complex health care claims in order to identify discrepancies, verify pricing, confirm prior authorizations and process them for payment. You'll need to be comfortable navigating across various computer systems to locate critical information. Attention to detail is critical to ensure accuracy, which will impact the timely processing of the member's claim.
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 equivalent work experience
Must be 18 years of age or older
Proficiency with Windows PC applications, including navigating multiple programs and learning new and complex computer system applications
Must be onsite at 115 W WAUSAU Ave, Waushu, 54401, and able to work full time at this location
Ability to work full time (40 hours/week), Monday – Friday, with flexibility for occasional overtime
Preferred Qualifications
1+ years of experience in a related environment (office, administrative, clerical, customer service, etc.) using phones and computers as primary job tools
1+ years of experience processing medical, dental, prescription or mental health claims
Compensation & Benefits Pay ranges from $17.98 to $32.12 an hour for full‑time employment, with compensation based on local labor markets, education, work experience and certifications. In addition to salary, we offer a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contributions (subject to eligibility). We comply with all minimum wage laws as applicable.
Equal Employment Opportunity UnitedHealth Group is an Equal Employment Opportunity employer. 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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