Claims Business Process Analyst - Wausau, WI

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.UnitedHealthcare, a UnitedHealth Group company, provides network-based health and well-being benefits and services for employers and consumers nationwide. We use our strength, diversity and innovation to improve the lives of the more than 18 million people who receive our unique products and services. And our endless pursuit for excellence in everything we do extends to your career as well. Join us today for an inspired and purposeful mix of professional growth opportunities and personal rewards.   Positions in this function are responsible for system coding of plan benefits, which allow claims to pay, pend, or deny at the plan level.   Primary Responsibilities:Program the plan benefit coding system by interpreting the claim installation documents and the customer's specific plan document. Maintain a working relationship with other units by developing coding schemes, clarifying, and resolving claim system coding capabilities. Review processing questions for possible benefit coding corrections. Participate in meetings by offering coding and auto adjudication suggestions and comments for new customers or changes to existing plans. Monitor claims on recycle and reasons for the claim inventory. Interpret and evaluate changes in laws and regulations and how they affect plan coding. Contribute to the team effort by accomplishing related results as needed. High school diploma or GED required 1 — 2 years medical or dental claim knowledge is required; medical claims preferred 1+ year customer service skills required Experience reviewing and analyzing installation documents is highly preferred Claim coding and adjudication is highly preferred 1+ year MS Office (Word and Excel) preferred Typing skills and data entry experience is preferredDiversity 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.