Claims Representative - Pittsburgh, PA

UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.Unison Health Plan, a unit of AmeriChoice, a UnitedHealth Group company, serves government health care programs in Western and Central Pennsylvania, Western Tennessee, Ohio, Delaware, South Carolina and Washington, DC, with managed care solutions designed for the states’ most medically vulnerable citizens.  Unison has always specialized in facilitating quality health care for beneficiaries of Medicaid and other state-sponsored health care programs, and has built a well-deserved reputation for its innovative approach to care and services.  Join us, do rewarding work, and build a great career.   Position Description:  Positions in this function are responsible for providing expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting claims. Authorizes the appropriate payment or refers claims to investigators for further review. Conducts data entry and re-work; analyzes and identifies trends and provides reports as necessary.   Primary Responsibilities:Extensive work experience within own function. Work is frequently completed without established procedures. Works independently. May act as a resource for others.  May coordinate others' activities.Qualifications:High school education or GED required. 6+ months typing experience required. 1+ years Claims processing and/or billing experience in the Health Insurance industry or Technical School education for claims processing required. Knowledge of Medical terminology and coding is preferred, i.e. ICD-9, CPT and HCPCS. Health insurance experience preferred. 1+ year customer service experience preferred. 6+ months of PC knowledge is preferred. Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V   UnitedHealth Group is a drug-free workplace.  Candidates are required to pass a drug test before beginning employment.