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Job Field: Environmental Jobs
Location: Irvine, CA
Salary: $Not stated

JOB SUMMARY:

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<tr><td valign="top" width="450"><b>Title: Medical Claims Review Specialist- Irvine, CALocation: US-CA-IrvineJob Number:_505665Position Description:<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />Positions in this function are 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.* Extensive work experience within own function.* Work is frequently completed without established procedures.* Works independently.* May act as a resource for others.* May coordinate other''s activities.Qualifications:Requirements:* High School Diploma or GED required* 1 year of medical claims processing experience required* ICD-9 and CPT coding experience and knowledge required* 1 year of provider contract interpretation experience required* 1 year of HMO claims experience required* Basic MS Word and Excel experience required* Knowledge of compliance and regulatory governing agencies (CMS,DMHC, and DHS) preferred<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />OptumHealthis part of the family of companies that make UnitedHealth Groupone of the leaders across most major segments of the US health care system.OptumHealth helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their health care needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.At OptumHealth, you will perform within an innovative culture that''s focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that''s greater than you''ve ever imagined.Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/VUnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.Job: Claim Quality

KEY REQUIREMENTS:

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