Recovery and Resolution Analyst - National Remote

UnitedHealth Group • Hartford, CT

389d • $48,298 - $94,494 • Remote

About The Position

The Recovery and Resolution Analyst position at UnitedHealth Group involves investigating and negotiating healthcare subrogation matters for a multi-million dollar portfolio. This role is crucial in ensuring compliance with healthcare regulations and laws while working to recover funds for clients. The analyst will engage in a variety of tasks including data analysis, legal research, and effective communication with various stakeholders throughout the subrogation recovery process. The position offers the flexibility to work remotely and requires a commitment to maintaining high standards of professionalism and integrity.

Requirements

• High School Diploma / GED
• Must be 18 years of age OR Older
• 2+ years of healthcare claims experience
• Experience working in healthcare insurance
• Understanding of subrogation principles
• Ability to work any of the 8-hour shift schedules during normal business hours

Nice To Haves

• P&C (Property & Casualty) insurance experience
• Demonstrated negotiation experience
• Knowledge of local, state and federal laws and regulations pertaining to insurance
• Experience working with claims and/or recovery

Responsibilities

• Investigate, evaluate, and negotiate healthcare subrogation matters for a multi-million dollar portfolio up to $20M (70%)
• Comprehend the nuances of Medicare, Medicaid, Self-Funded ERISA and Non-ERISA related health insurance subrogation recoveries and reimbursements
• Research applicability of laws, regulations and other requirements to cases, contracts or decisions
• Analyze data and interpret legal research to make conclusions and present results
• Maintain working knowledge of ERISA and ensure adherence to state and federal subrogation laws
• Identify, monitor and evaluate data to determine third party liability and reimbursement amounts
• Conduct a high volume of outbound calls and respond to inquiries (20%)
• Communicate effectively with various parties throughout the subrogation recovery process
• Validate claim liability, adjuster's contact information, claim status, and treatment status
• Thoroughly document all communications and maintain case activity calendar diaries (10%)
• Ensure compliance with Health Insurance Portability and Accountability Act
• May be involved with litigation as necessary
• Negotiate settlements with adverse parties with professionalism and integrity
• Recommend and participate in round table discussions of complex cases
• Act as coach and mentor to other team members
• Assist management on special projects and any other assigned tasks

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Insurance Carriers and Related Activities
• Education Level: High school or GED