Healthcare Business Analyst, Claims - Fraud/Abuse expert needed!

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.



Ingenix, a UnitedHealth Group company, is one of the largest health care information and research companies in the industry. No one competitor offers the same breadth of products and services as Ingenix. In fact, our competitors strive to copy what we have done. We offer the most comprehensive set of data, technology and analytic capabilities. The power of our products and services help customers leverage information assets, enhance clinical and financial insight, increase the quality of health care delivery and administration and improve cost management.



We are hiring a new Business Analyst in our Medicaid claims department-a role that offers claims professionals a chance to showcase excellent problem-solving and analysis skills while enjoying all the perks that come with working for an industry leader. If you're seraching for a new way to use your talents, we invite you to consider joining our friendly team.



The chosen applicant may work out of our offices in Portland, ME; Chicago, IL; or Minneapolis, MN.



Key responsibilities include:


Creating algorithms to identify problematic claims


Working with the database developer to create criteria for queries


Comparing claims with established limits to determind patterns of overpayment
Presenting potential algorithms to clients in person or on the phone

Job Requirements:

Extensive claims experience is essential for this position, as is significant data analysis experience. A background reviewing claims for overpayment is ideal. Detailed claims analysis experience and/or experience supervising claims specialists will be valuable. Prior worki with health insurance benefits is preferred, and experience using MS Access is a plus.



UnitedHealth Group offers a full range of comprehensive benefits, including medical, dental and vision, as well as a matching 401k and an employee stock purchase plan.



If you are interested in growing professionally within an innovative, highly respected organization, we invite you to explore this excellent growth opportunity!



Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V.



Keywords: healthcare, insurance, claims, benefits, analyst, claims manager, claims analyst, medical, hospital, data, Medicaid, analytical, analytics, fraud investigator, fraud investigation