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Claims Support Specialist - Charleston, WV
Claims Support Specialist - Charleston, WV-March 2024
Charleston
Mar 21, 2025
ABOUT UNITEDHEALTH GROUP
With offices around the world, UnitedHealth Group's headquarters are located in the Minneapolis metropolitan area.
10,000+ employees
Healthcare
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About Claims Support Specialist - Charleston, WV

  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 and start doing your life's best work.SM

  Imagine this. Every day, in claims centers around the world, UnitedHealth Group is processing and resolving payment information for millions of transactions. Would you think we have some great technology? Would you think we know how to manage volume? You would be right. No one's better. And no company has put together better teams of passionate, energetic and all out brilliant Claims Representatives. This is where you come in. We'll look to you to maintain our reputation for service, accuracy and a positive claims experience. We'll back you with great training, support and opportunities.

  The Claims Support Specialist enters claim status information into the Electronic Database Interchange to provide exact claim status information to clients, ensuring accuracy and completeness. Additional responsibilities include conducting investigations to determine claim coverage in accordance with benefit plans. Previous experience handling workers compensation claims is beneficial to office operations.

  This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work our normal business hours of (8:00am - 5:00pm EST). It may be necessary, given the business need, to work occasional overtime. Our office is located at 602 Virginia Street East, Charleston WV.

  Primary Responsibilities:

  Handle appeals and reworks Execute payment recovery procedures Research claim inquiries and histories Follow-up with Insurers and Providers to resolve problems and answer questions Operate claims system and reference plan documents to research claim issues Demonstrate satisfactory performance levels in relation to production, quality standards, and attendance Maintain compliance with Company policies and Procedures Provide phone back-up for the Customer Service department Communicate with internal and external customers regarding benefit and claim issues Administrative functions such as typing, photocopying, faxing, filing, scanning, indexing, and data entry

  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 years of work experience Proficiency with Windows PC applications, which includes the ability to navigate multiple programs and learn new and complex computer system applications Must be 18 years of age OR older Ability to work full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work our normal business hours of (8:00am - 5:00pm EST).

  Preferred Qualifications:

  1+ years of experience in a related environment (i.e. office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools 1+ years of experience processing medical, dental, prescription or mental health claims

  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.

  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.

  #RPO #RED

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