22 days old

Specified Disease Analyst - Fort Worth, TX

Fort Worth, TX 76102
  • Job Code
    885620

Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.SM


Opportunities with USHEALTH Group and subsidiaries. A career with the USHEALTH Group family of companies makes you part of a team providing innovative, flexible and affordable health coverage plans. We're now part of UnitedHealthcare and the UnitedHealth Group family of businesses, backed by the resources of a global health organization working to help people live healthier lives and to help make the health system work better for everyone. From our management team and staff to the independently contracted Agents of USHEALTH Advisors, we're united in a mission of HOPE: Helping Other People Everyday. If you're drawn to the same commitment to making a positive difference in the lives of others, consider a role with USHEALTH Group and Subsidiaries.

Are you ready to be part of the solution that people are looking for? Take a closer look at USHEALTH Group family of companies, where your passion can drive results and your life's best work.(sm)


The Specified Disease Analyst provides claim service to policyholders by analyzing specified disease to determine the extent of the company's liability. Claims are processed according to established procedures within authorized payment amount limits.


Primary Responsibilities:

  • Review claims with related documentation to calculate the amount of benefits payable or to determine the basis for denial of benefits, within policy provisions and limitations
  • Investigate and obtain necessary documentation to substantiate initial claims received with insufficient information. This involves pending such claims to request information from the policyholder or contacting the providers to obtain needed information for processing the claim
  • Process suspended claims upon receipt of previously requested information
  • Continue to follow-up with attempts to obtain required information so the completion of the claims processing cycle can occur
  • Interfaces with providers and other insurance carriers as needed regarding information necessary for processing the claim
  • Correct audits returned from supervisors or customer service

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.

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Posted: 2020-09-01 Expires: 2020-10-08

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Specified Disease Analyst - Fort Worth, TX

UnitedHealth Group
Fort Worth, TX 76102

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