UnitedHealth Group Looking for Claims Representative Associate – Work From Home at Kingston, NY

  • Anywhere

UnitedHealth Group

If you are located within state of New York, you will have the flexibility to telecommute* (work from home) as you take on some tough challenges. Be part of our next training class and begin your new career. Apply today!

You dream of a great career with a great company – where you can make an impact and help people. We can offer you just this. And with the incredible growth of our business, it’s a dream that definitely can come true when you join us as an Associate Claims Representative. Already one of the world’s leading health care companies, UnitedHealth Group is tirelessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. Whether you have prior experience or not, we’ll provide extensive training and a highly supportive environment for all of our Claims team members. This is your opportunity to make a difference, grow your career and do your life’s best work.SM

As an Associate Claims Representative, you’ll be responsible for analyzing complex healthcare claims that require research to determine action steps and mathematical calculations necessary to produce an accurate payment. The claims position requires a high level of quality which is to be maintained while achieving a productivity goal. You’ll put your skills and talents to work as you review, research, and process medical claims. It’s complex, detailed work. It’s a fast-paced challenge. It’s a job that calls on you to be thoughtful, resourceful, team-driven and customer-focused. To put it mildly, there is never a dull moment.

This position is full-time (40 hours/week) Monday – Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 6:00am – 6:00pm. It may be necessary, given the business need, to work occasional overtime.

  • All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

There are several steps in our hiring process – it’s a thorough process because we want to ensure the best job and culture fit for you and for us. In today’s ultra-competitive job market, the importance of putting your best foot forward is more important than ever. And you can start by completing all required sections of your application. (i.e. profile, history, certifications and application/job questions). Once you submit your resume, you’ll receive an email with next steps. This may include a link for an on-line pre-screening test that we ask you to complete as part of our selection process. You may also be asked to complete a digital video interview, but we will offer full instructions and tips to help you. After you have completed all of these steps, you can check on the status of your application at any time, but you will also be notified via e-mail. http://uhg.hr/OurApplicationProcess


Primary Responsibilities:

  • Review, research, solve and process assigned work. This would include navigating multiple computer systems and platforms (e.g. verify pricing, prior authorizations, applicable benefits)
  • Ensure that the proper benefits are applied to each claim by using the appropriate tools, processes and procedures (e.g. claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/ certificates tool)
  • Independently complete on a daily basis all documentation and communicate the status of claims as needed adhering to all reporting requirements
  • Communicate through correspondence with members and providers regarding claim payment or required information, using clear, simple language to ensure understanding
  • Learn and leverage new systems and training resources to help apply claims processes/procedures appropriately (e.g. on-line training classes, coaches/mentors)
  • Meet and maintain the performance goals established for the position in the areas of quality, production and attendance
  • Consistent attendance with ability to meet work schedule including the required training period
  • Successful completion of the UnitedHealth Group 12 to 14-week new hire training program which is 60% instructor lead and 40% self-paced learning (requires ability to read complex information and demonstrate proficiency through testing and practical application)

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.


Required Qualifications:

  • High School Diploma / GED (or higher) OR 10+ years of equivalent working experience
  • Working knowledge with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications (including comfort using macros efficiently)
  • Experience working with multiple products and multiple levels of benefits within each product


Telecommuting Requirements:

  • Reside within state of New York
  • Required to have a dedicated work area established that is separated from other living areas and provides information privacy
  • Ability to keep all company sensitive documents secure (if applicable)
  • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service


UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.


Military & Veterans find your next mission:
We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at https://uhg.hr/transitioning-military

Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible. https://uhg.hr/vet


Careers at UnitedHealthcare Employer & Individual
. We all want to make a difference with the work we do. Sometimes we’re presented with an opportunity to make a difference on a scale we couldn’t imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you’ll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You’ll help write the next chapter in the history of healthcare. And you’ll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life’s best work.SM

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.


UnitedHealth Group
is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.

Keywords: medical claims, healthcare claims, claims representative, claims rep, claims processing, claims processor; UnitedHealth Group, UnitedHealth care, training class, work at home, work from home, WAH, WFH, remote, telecommute, hiring immediately, #RPO

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