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Ability to read, interpret and comprehend insurance payment Remittance Advice/ Explanation of Benefits Review, appeal or request claim reprocessing to represent correct processing of insurance claims Contact insurance companies regarding claim processing and determining reason for payment delinquency or claim denial Contact various departments to help with corrections and submit appeals for outsta
Posted 5 days ago
Ensure all solutions adhere to enterprise IT principles, standards, and healthcare industry standards and regulations Responsible for intake scoping, solution concepts and initial cost estimation; system architecture definition at the logical level Define architecture blueprint for end to end systems to including integration of applications, systems, platforms and technical infrastructure Work clo
Posted 6 days ago
Authorize healthcare services in compliance with contractual agreements, health plan guidelines and medical necessity criteria Maintain clinical expertise and maintain knowledge of scientific progress in nursing and medical arena and incorporate this information into the review and case management processes Maintain logs and proper documentation of cases reviewed, case management activities and
Posted 6 days ago
We are offering a $2,000 sign on bonus for new hires! Our practice is open Monday Friday 8am 5 30pm and we are located at 13402 W. Coal Mine Avenue in Littleton. Opportunities with New West Physicians. Bring your passion for health care to New West Physicians in Colorado, a team committed to providing excellent service to every patient... every time. We're not only one of the largest physician gro
Posted 6 days ago
Accountable for successful deployment of UHC's Clinical Support Care Coordination program, UHC Spectrum, at the practice level, including but not limited to integration of care coordination for pharmacy management, care transitions management, and referral management Build and effectively maintain relationship with the practice leadership and key clinical influencers actively involved in pract
Posted 6 days ago
Opportunities with New West Physicians. Bring your passion for health care to New West Physicians in Colorado, a team committed to providing excellent service to every patient... every time. We're not only one of the largest physician groups in Colorado with 21 offices throughout the Denver Metro area we're also part of Optum, a nationwide family of nearly 45,000 dedicated physicians working toget
Posted 6 days ago
Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, lease restrictive level of care Identify and initiate referrals for social service programs; including financial, psychosocial, community and state supportive services Manage the care plan throughout the continuum of care as a single point of contact Communicate with all stakehol
Posted 7 days ago
This isn't HR. This is Human Capital at UnitedHealth Group. Here, you're expected and empowered to be your best, to grow and to develop your skills. Join us and help people live healthier lives while doing your life's best work.(sm) Trainers with UnitedHealth Group have the opportunity to train talented individuals and exceptional professionals. This a great opportunity to effect the delivery of t
Posted 8 days ago
Remain up to date with the contract requirements Use clinical judgement to ensure a clear, comprehensive and concise exam documentation that is reflective of the patient's service level conditions and in compliance to contract requirements Interpret and document diagnostic test results Educate and support provider with navigating and utilizing medical history information and prior disability claim
Posted 8 days ago
Assist in answering incoming phone calls in a prompt and professional manner Return calls as appropriate Connect and disconnect answering service, and follow up on messages received from answering service Assist in taking phone messages in a concise and complete manner Ensure phone calls will not be left on hold for excessive periods of time Assist "unscheduled" emergencies to the point that medic
Posted 13 days ago
Assist providers with examinations, minor surgical procedures and physicals May be required to perform certain tasks alone as instructed. These procedures may include but are not limited to Medical Duties Injections, sterile field set up, EKG, application of dressings and splints, PFT's, mass removal, flexible sigmoidoscopy, pap smears, pulse oximetry, orthostatic blood pressures, audiograms, spir
Posted 13 days ago
Oversees and coordinates due diligence efforts for acquisition targets. Directs the strategic planning and management of the integration projects and team to ensure that the goals and objectives are accomplished within the prescribed time frame. Directs the project management and process improvement activities to achieve optimal implementation and control outcomes. Identifies risk issues that impa
Posted 13 days ago
Doing the right thing is a way of life at Rocky Mountain Health Plans (RMHP). As part of the UnitedHealthcare family of plans, RMHP provides innovative health insurance coverage and personalized attention to individuals of all ages and business of all sizes throughout Western and rural Colorado. RMHP is continually striving to improve the health and wellness of our Members and partners in the stat
Posted 13 days ago
UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) Doing the right thing is a way of life at Rocky Mountain Hea
Posted 14 days ago
UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) Doing the right thing is a way of life at Rocky Mountain Hea
Posted 14 days ago
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