Provider Claims Liaison - NY based (remote)

About the position

The Provider Claims Liaison role at UnitedHealth Group is focused on educating and supporting contracted providers regarding NY Medicaid billing requirements and methodologies. This position serves as a key point of contact for resolving service issues, facilitating communication between providers and internal teams, and driving improvements in provider satisfaction. The role requires a strong understanding of claims processing and provider relations, with a commitment to enhancing the overall healthcare experience for providers in New York.

Responsibilities
• Educate contracted providers and internal staff on NY Medicaid billing requirements and methodologies.
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• Serve as point of contact for centralized service units to resolve/manage service issues.
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• Initiate expedited resolution actions and monitor progress until complete resolution is achieved.
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• Reinforce provider education activities regarding service resolution paths.
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• Facilitate management of complex service issues in conjunction with the Market Lead.
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• Collate, evaluate, and report on service issues/risks/trends to support contract negotiations.
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• Identify and resolve global root cause drivers of claims/service issues.
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• Communicate frequently with providers to ensure effective information exchange and gather feedback.

Requirements
• 5+ years of experience in a managed health care environment working with the insurance side of the business.
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• 2+ years of experience with NY Medicaid billing and methodology.
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• Experience working with NY providers.
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• Claims and billing experience (e.g., Claims processor, Claims auditor, Claims examiner, Certified Coder).
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• Experience with provider relations issue resolution and conflict management skills.
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• Proven ability to meet performance metrics (turn-around time, issue resolution, root cause analysis).
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• Proven ability to drive resolution and work independently with minimum supervision.
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• Solid verbal and written communication skills.
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• Must reside in NY.
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• Ability to travel 25% of the time within NY State.

Nice-to-haves

Benefits
• Comprehensive benefits package
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• Incentive and recognition programs
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• Equity stock purchase
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• 401k contribution

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