
Payment Integrity Analyst
hace 21 horas
Overview of Optum
">Optum is a leading global healthcare organization dedicated to delivering care and technology solutions that improve health outcomes. Our team is passionate about creating a better future for patients and healthcare professionals alike.
">Recovery Resolutions Analyst RN/Coder Role
">In this critical role, you'll analyze medical records, investigate disputed claims, and make complex payment decisions that impact both healthcare providers and UnitedHealth Group/Client.
">Key Responsibilities
">- ">
- Investigate and review post-service, pre-payment or post-payment claims">
- Analyze and interpret data and medical records/documentation to ensure accuracy">
- Communicate findings to senior leadership and work with healthcare providers to resolve disputes">
- Maintain daily case review assignments with high emphasis on quality (at least 98% accuracy)">
- Assume additional responsibilities as assigned and participate in client/network meetings">
Requirements and Qualifications
">To excel in this role, you should possess a valid RN license or certified coder credentials, at least one year of experience in a production-driven environment with quality audit standards, and proficiency in Microsoft Office Suite.
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Clinical Resolution Specialist
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