Remote Claims Resolution & Coding Specialist

Taleo; Dallas (TX); Remote; USD 73,000 - 130,000; Full time

Job summary

UnitedHealth Group is seeking a Recovery Resolution Consultant to support complex coding cases and drive quality improvements. This National Remote role focuses on mentoring teammates, developing clinical job aids, and coordinating with multiple teams to resolve claims efficiently.

You will analyze claims, participate in bi-weekly huddles, and contribute to risk management, fraud prevention, and process optimization.

Qualifications

• High School Diploma / GED.
• Certified AHIMA OR AAPC coder (CPC, CCS, CCA).
• 2+ years as AHIMA/AAPC certified coder.
• Understanding of Fraud, Waste, Abuse and Error principles in health insurance.
• Knowledge of health insurance terminology and regulatory guidelines.
• Experience leading projects or teams, including mentoring or coaching.
• Able to work full-time Monday - Friday within 8am-5pm.

Responsibilities

• Provide assistance, feedback, and action in daily/monthly reporting (Quality, Automation, Platforms).
• Aid in writing and implementing process improvements (process mapping, job aids, PNP).
• Create and present ongoing development and training for production staff.
• Assist inventory management, task assignment and timely escalations.
• Respond to complex coding case questions on SME/MD portal.
• Support quality metric activities and related meetings.

Skills

Communication

Organization

Problem-solving

Analytical thinking

Client service

Education

High School Diploma / GED

AHIMA/AAPC coder certification

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

Job description

UnitedHealth Group is seeking a Recovery Resolution Consultant to support complex coding cases and drive quality improvements. This National Remote role focuses on mentoring teammates, developing clinical job aids, and coordinating with multiple teams to resolve claims efficiently.

You will analyze claims, participate in bi-weekly huddles, and contribute to risk management, fraud prevention, and process optimization.