Senior Claims Quality/Audit 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.   Primary Responsibilities:Responsible for all aspects of quality assurance within the Claims job family. Conducts audits and provides feedback to reduce errors and improve processes and performance. Work does not usually require established procedures. Works independently. Mentors others. Acts as a resource for others. Coordinates others' activities. Extensive work experience, possibly in multiple functions. Qualifications:High school diploma or GED is required; Bachelor's degree is preferred. 2+ auditing and/or claims experience, preferably in the healthcare industry 2+ years experience with MS Office (Word and Excel) required 1+ year with medical terminology require Experience with FACETS highly preferred Coding experience highly 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.