National Recoveries Consultant

About the role

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities.

Responsibilities

• Class Action:
  • Review settlement terms and filing requirements and prepare summary of case.
  • Request data from all client data sources, providing case summary, parameters and standard data elements.
  • Prepare necessary communications, reporting, and claim filing.
  • Upon receipt of payments, prepare financial statements and update reporting.
• Mass Tort:
  • Review case, terms and participation requirements upon receipt of Notice of Tort Action.
  • Receive Plaintiff Lists from external law firms and lien resolution groups; prepare member data match and retrieve claim histories.
  • Review claim histories and build relevant liens to submit for recovery.
  • Pull data into a standard template for Lien Resolution Program negotiation.
  • Upon receipt of payments, prepare financial allocation and update reporting.
  • For states that preclude subrogation, obtain policy language to prove subrogation rights.
  • Follow up with external law firms and lien resolution groups on aging liens.
• Litigation Data Analytics & Legal Support:
  • Work closely with UHG legal teams, providing support in data collection, analysis, matching for various ongoing litigation efforts.
  • Participate in the development and implementation of evolving processes and best practices related to legal data requests and recovery operations.
  • Serve as a subject matter resource for claims, member, and financial data utilized in litigation support activities.

Requirements

• High School Diploma / GED OR equivalent years of experience.
• Must be 18 years of age OR older.
• 2+ years of experience in interpreting and analyzing large data sets.
• Understanding and knowledge of health care claims.
• Intermediate level of proficiency with Microsoft Excel (sorting, summing, creating bar graphs, and formulas such as pivot tables and lookups).
• Experience with computers and Windows based programs.
• Ability to work any of our full time, 8-hour shift schedules during our normal business hours of 7:30 am – 5:00 pm EST from Monday – Friday, including the flexibility to work occasional overtime given the business need.

Preferred Qualifications

• 2+ years of experience in claims recovery and resolution, subrogation, litigation support, healthcare operations or a related operations-based environment.
• 2+ years of experience working in collections, negotiations, mediations, arbitrations, or legal support; preferably in the health insurance industry.
• 2+ years of experience in Fraud, Waste, Abuse & Error.
• Leadership experience.
• Familiarity with SAS, building, and exporting data.
• Advanced proficiency with Microsoft Excel (data analysis functions).
• Experience with leveraging tools such as macros or AI to improve operational efficiency.

Telecommuting Requirements

• Ability to keep all company sensitive documents secure.
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.

Soft Skills

• Strong analytical, problem-solving, and critical-thinking skills.
• Ability to identify data discrepancies and perform data quality validation.
• Excellent written and oral communication skills.
• Attention to detail.

Pay

The salary for this role will range from $72,800 – $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.