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Risk Analyst - National Remote - 2232177

UnitedHealth Group

UnitedHealth Group

Minnetonka, MN, USA
Posted on Tuesday, July 9, 2024

Opportunities with HealthMarkets LLC and subsidiaries, a UnitedHealthcare company. Join an established team that’s dedicated to simplifying the health care system so that people have the opportunity to feel their best through accessible insurance options. We will support you with our deep industry knowledge and technology so that you can take on a rewarding career, helping people find the care they need. Take on a career that enables you to make an impact as you discover the meaning behind Caring. Connecting. Growing together.

Conducts Eligibility Verification audits on in-force groups to ensure the group continues to meet the definition of a small employer as defined by their benefit contract. Audits performed verify both group and member level eligibility, participation, and consider factors including group and individual risk, common ownership, PEO, and business segment.

You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

  • Conduct eligibility verification audits and reconcile tax documents for group and member level eligibility
  • Communicate regularly to build and maintain solid relationships with RAE, inside sales, financial underwriters, customer service, and agents regarding case status and audit related issues
  • Communicate decisions/analysis in a concise professional manner that non-auditing personnel will understand
  • Interpret Group Policies, COCs, legislative and compliance regulations
  • Maintain reporting and tracking database for assigned groups
  • Ability to meet TAT and productivity goals set by management
  • Maintain current knowledge and understanding of HIPAA and PHI regulations
  • Takes initiative to identify and resolve issues

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:

  • 1+ years equivalent work experience in insurance or healthcare and/or auditing, underwriting, enrollment or degree in a related field of study
  • Proven solid analytical, problem solving and critical decision-making skills
  • Demonstrated ability to meet TAT and productivity goals set by management
  • Knowledge of Insurance Industry and Products
  • Proven intermediate level of proficiency with Microsoft Office applications
  • Demonstrated ability to learn platforms/systems

Preferred Qualifications:

  • Associates Degree or bachelor’s degree in Math, Finance, Business, or related degree
  • Knowledge of Tax Documents in an audit setting
  • Knowledge of Small Business Insurance requirements
  • Proven solid verbal and written communication and customer service skills
  • Demonstrated ability to prioritize, organize, and utilize good time management skills in a fast-paced environment
  • Demonstrated ability to work both independently and in a team
  • Proven solid attention to detail
  • Experience risk management function supports the company’s goals, mission statement, and strategic objectives, and recognizes how other departments interrelate
  • Proven current knowledge and understanding of HIPAA, ACA, PHI, and PII regulations

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The salary range for this role is $48,300 to $94,500 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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.