Senior Claims Business Process Analyst

Requisition Number: 2373110
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.
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
The Senior Claims Business Process Analyst is responsible for supporting end-to-end claims process oversight, analysis, quality assurance, and process improvement initiatives. The role partners closely with business, operational, and technical teams to analyze claims system utilization, conduct capacity planning and reporting, and perform claims related business and system analysis.
This position is full time (40 hours / week) in their respective time zone, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift, flexible hours schedules during our normal business hours of 6:00 am - 6:00 pm. It may be necessary, given the business need, to work occasional overtime.
We offer 4 - 6 weeks of on-the-job training. The hours of training will be aligned with your schedule.
Primary Responsibilities:

• Perform in-depth, end-to-end research, data analysis, and root cause analysis to support claim quality remediation from initial issue identification through resolution
• Own quality assurance activities related to payment accuracy, claim outcomes, and process improvement initiatives
• Evaluate claim scenarios across the Facets platform, workflows, and business rules to identify gaps, trends, and downstream impacts
• Partner with stakeholders to assess system changes, operational process enhancements, and remediation opportunities
• Maintain claims process documentation, workflows, standards, and tracking tools to support consistency and audit readiness
• Support capacity planning, reporting, and trend analysis to drive operational awareness and decision-making
• Use data and claim findings to recommend solutions, improve processes, and support long-term operational effectiveness

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 equivalent work experience
• Must be 18 years of age OR older
• 2+ years of experience with analyzing and solving business OR customer issues
• 2+ years of experience in conducting end to end audits
• Ability to manage multiple priorities in a fast paced environment
• Proficiency with Windows-based applications and ability to learn complex systems and issues
• Facets experience
• Ability to work full time (40 hours / week) in their respective time zone, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift, flexible hours schedules during our normal business hours of 6:00 am - 6:00 pm. It may be necessary, given the business need, to work occasional overtime.

Preferred Qualifications:

• Claim adjustment experience
• SharePoint experience

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

*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 $24.00 - $43.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
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.