Claims Services Super User (Temporary - 8 Month Assignment)

7 days left

Minneapolis, Minnesota
Apr 08, 2021
Apr 23, 2021
Employment Status
Full Time
Health Care that Starts with You!

Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota's leading health plans. We provide more than 225,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs.

UCare is growing in size, membership, products, geographic coverage, and employees. We're an organization that's going places. Be part of a team that cares about you, be part of UCare.


Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You'll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis just minutes from major freeways and retail centers.

At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.



ABOUT UCARE UCare offers Medicare, Medicaid, Individual and Family health plans - powered by the hardest working people in the industry. Our people powered teams de-complicate, advocate and always go the extra mile to help our members. We serve with integrity, compassion and commitment to do right by members, providers and government partners. Above all, we come to work excited to provide members a path for the best health of their lives.

WORKING AT UCARE Working at UCare is more than a career; it's a mission. A mission that defines us as professionals, unites us as an organization and shapes how we interact with our members and each other. Employees join UCare and stay because of the opportunity to have a purpose-driven job.

Our strong culture has established UCare as a Star Tribune Top 150 Workplace for 11 consecutive years since the awards program began. It's a culture that embraces innovative ideas, strategic partnerships, and exemplary customer and provider experiences. Working at UCare is being a part of a people powered team dedicated to making a real difference in the lives of our members and communities.


Position Description
This position is responsible to provide claims adjudication system and process subject matter expertise to support the day-to-day work of the Claims Services Team. Act as liaison between Claims Services Team and the CCO Business Analysis and CCO Audit & Compliance Teams to translate process, training, and compliance improvement opportunities. Change agent to communicate and champion process and system changes to staff and leaders within Claims Services Team. Support Claims Services Manager in identify and resolving member and provider issues.

• Provide HealthRules and/or Amisys system navigation expertise to staff and leaders.

• Ensure consistent and timely execution of claims services processes (e.g. letters, member reimbursements, recoveries).

• Partner with CCO business analysis and CCO audit & compliance teams to support the communication and execution of internal project, audit, process documentation and training efforts.

• Monitor and manage high dollar claims.

• Identify and recommend enhancements to Claims Services business processes and systems.

• Identify and resolve escalated member and provider escalated issues.

• Identify and recommend enhancements to job aids, work instructions and training.

• Coach and mentor staff.

• Champion system, process and product changes within the Claims Services Team.

• Other projects and duties as assigned.

Bachelor's degree, experience may be considered in lieu of degree.

Required Experience
Three years experience in medical claims processing. Knowledge of Commercial, Medicaid and Medicare insurance products.

Preferred Experience
Business process management or improvement experience. Medicare, Medicaid and/or Commercial product knowledge.

The UCare difference is our people power - employees actively working on the behalf of our members to get them access to the health care they need. We value and respect each individual's ideas and contributions, and provide the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, and a myriad of volunteer activities. If you're looking for an inclusive environment that celebrates your people power, helps you build on your strengths and gives you the opportunity to truly make a difference, we invite you to apply.

As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.

JOB POST DATE: 04/07/2021

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