This position is National Remote. You'll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges. Imagine being able to get answers to your health plan questions from someone who speaks the same language as you do. Or, the opposite, not being able to get the answers. At UnitedHealth Group, we want our customers to get those answers by speaking to one of our Bilingual Representatives. If you're fluent in English and Japanese, we can show you how to put all of your skills, your passions and your energy to work in a fast- growing environment. At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The Global Care Consultant is the core support for UnitedHealthcare Global's traveling members in need. No workday will be the same as you will be responsible for coordinating various medical and travel assistance for and with our partners, customers, and service providers. You will also work closely with our in-house Clinical team, Healthcare Intelligence, and Claims staff to provide superior customer support. You will provide assistance to customers requiring medical care, including emergency support, medical assistance, appointment arrangements, medical referrals, billing arrangements, travel assistance, arrangement of medical evacuations and repatriation, and general customer service. You will be responsible for maintaining accurate case records, working as a part of a cohesive team, and providing ongoing and comprehensive service to our members abroad and in the USA. The Emergency Response and Assistance Center operates 24 hours a day, 7 days a week, 365 days a year, requiring individuals willing to work flexible schedules including weekends and holidays on a rotating basis. We are looking for people who enjoy learning and are critical thinkers. This position follows the shift bid process for scheduling. This is a 24/7 call center department. Candidates must have the flexibility to work either four 10-hour shifts or five 8-hour shifts weekly based on the shift bid, including weekend shifts (every other weekend on average) and holidays (rotating) Shift bid is 1 time per year and priority is given based on department seniority then organizational seniority. We offer weeks of on-the-job training. The hours of training will be aligned with your schedule. Primary Responsibilities: Serve as a team member in the 24 / 7 Emergency Response and Assistance Center Answer a high volume of calls according to client and member specific service requirements First point of contact to coordinate medical assistance services for travelers experiencing a medical emergency or requiring medical treatment Manage all aspects of a domestic or international assistance case from opening to closing Serve as the first point of contact for members, end users, clients, service providers and colleagues to ensure all calls are answered promptly, appropriately, and courteously Answer inbound telephone or email inquiries and assistance requests and ensure continuity of service delivery by answering all requests for assistance in a timely and professional manner Coordinate actions with in-house Clinical Team, travel agents, Healthcare Intelligence, claims, and other internal functional areas involved in a case Coordinate cases in an efficient and cost-effective manner in accordance with company policies and procedures Demonstrate an understanding of all key clients' Operations and Billings Procedure and able to apply in live case management Developing a knowledge base and degree of assurance to explain necessary information clearly and ensure that the customer fully understands the assistance UHCG provides Ensure that sufficient logistic arrangements are made in a timely and appropriate manner to meet the needs of members and clients Communicate case status with stakeholders including senior leaders, clients, patients, and family members by telephone, email, teleconference, etc. Take ownership and manage cases with a view to moving them forward in the best interests of the member and client Manage an allocated load of cases within the working hours and ensure that it is communicated appropriately and efficiently in the transmission during case hand off 100% Customer Service Focused and Quality delivery is required in this role Able to work in a fast paced, flexible environment Strong attention to detail Other duties/projects as assigned This role is equally challenging and rewarding. You'll need to always stay positive, especially in difficult situations. You'll be asked to communicate effectively with individuals and team members around the world. 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 3+ years of equivalent work experience in an office setting environment using the telephone and computer as the primary instruments to perform job duties Must be 18 years of age OR older 2+ years of customer experience analyzing and solving customer problems in an office setting environment using the telephone and computer as the primary instruments to perform job duties Experience with Microsoft Outlook (ability to create and send professional communications utilizing proper sentence structure and grammar) Bilingual fluency in English and Japanese Ability to work variable hours or any given shift in a 24 hours / 7 days department - the role requires every other weekend as well as rotating holidays. It may be necessary, given the business need, to work occasional overtime Preferred Qualifications: 3+ years of healthcare experience with a focus in global environment, world/geographic understanding, and empathizing with challenges while traveling Call center and/or medical assistance experience Experience with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications Telecommuting Requirements: Ability to keep all company sensitive documents secure (if applicable) Required to have a dedicated work area established that is separated from other living areas and provides information privacy Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service Soft Skills: Ability to multi-task including ability to understand multiple products and multiple levels of benefits within each product Delivers white glove, high quality customer service Takes ownership of inquiries and liaises between departments to provide seamless service Possesses Culture Competence and awareness on global scale, including the abilirt ro overcome cultural and language barriers to provide assistance Ability to adapt in a dynamic work environment and make independent decisions Ability to drive change and process improvements Experience evaluating critical situations and apply case handling instructions and standard operation procedures to make appropriate treatment and logistic decisions Experience with complex task management and the ability to learn complex systems and processes Experience communicating complex information in a clear and concise manner while using appropriate grammar both verbally and in writing to stakeholders Experience working within an insurance, global vendors or healthcare role and related regulations (privacy, HIPAA, compliance) Experience maneuvering multiple computer screens with the ability to navigate a fast paced, highly matrixed organization effectively Strong knowledge of international travel and ability to work independently to identify root cause and solution to case work issues, and driving the initiative to correct it with minimal guidance Experience handling complaints by investigating member or provider concerns and coordinating responses with other functional areas, departments, and vendors as appropriate Ability to coach and mentor new team members to develop in role and ensure appropriate knowledge transfer in order to meet team objectives All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.38 - $36.44 per hour based on full-time employment . click apply for full job details

This position follows a hybrid schedule with 1 in-office day per week. Our office is located at 5003 Commercial Circle, Concord, CA 94520. Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together. The Medicare Recovery Audit Specialist is responsible for identifying and addressing improper Medicare payments through retrospective claims review. This role ensures compliance with Medicare regulations, CMS guidelines, and internal policies by analyzing medical records, billing data, and coding accuracy. The Specialist works collaboratively with internal departments to support audit responses, appeals, and compliance improvement initiatives. 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 8:00 am - 5:00 pm. This will be on the job training and the hours during training will be during normal Business hours Primary Responsibilities: Conduct audits and reviews of Medicare claims to identify overpayments, underpayments, and non-compliance with CMS regulations Analyze medical records, billing documentation, and coding to ensure accuracy and appropriate reimbursement Apply CMS guidelines, Medicare National and Local Coverage Determinations (NCDs/LCDs), and regulatory requirements during audits Prepare detailed audit findings, reports, and documentation to support determinations Participate in appeal preparation by compiling records, drafting rebuttals, and supporting appeals processes as needed Communicate audit findings and recommendations to internal stakeholders, including compliance, billing, coding, and clinical teams Track audit outcomes, trends, and recurring issues to recommend process improvements and risk mitigation strategies Maintain strict confidentiality and security of protected health information (PHI) Stay current with Medicare policies, CMS updates, coding changes (ICD-10, CPT, HCPCS), and RAC program requirements 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 Must be 18 years OR older Working knowledge of Medicare remittance advice, recoupments, and appeals processes, including experience working with Medicare Administrative Contractors (MACs) Experience with CMS/Medicare billing, including UB 04 form requirements and CMS/Medicare policies Experience with Electronic Health Records (EHR) & Practice Management Systems (PMS) Proficient with Microsoft Office (Microsoft Excel, Microsoft Word, Microsoft Outlook, Microsoft Powerpoint) Ability to work onsite one day per week at 5003 Commercial Circle, Concord, CA 94520, with the remaining days worked remotely Ability to work 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 8:00 am - 5:00 pm Preferred Qualifications: Experience with Epic EHR Telecommuting Requirements: Reside within commutable distance to the office at 5003 Commercial Circle, Concord, CA 94520 Ability to keep all company sensitive documents secure (if applicable) Required to have a dedicated work area established that is separated from other living areas and provides information privacy. Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service. Soft Skills: Strong communication skills to clearly convey audit findings and collaborate with clinic managers and physicians on solutions. Strong analytical and organizational skills All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.38 - $36.44 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. 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