Hospital Bill Audit Eligibility and Research Associate 2383798 | Dallas, Texas | Remote

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Connecting. Growing together. With these values to guide us, our people are committed to making a meaningful difference in the lives of those we are honored to serve. Integrity Compassion Inclusion Relationships Innovation Performance Back to nav Hospital Bill Audit Eligibility and Research Associate Requisition number: 2383798 Job category: Claims Primary location: Dallas, Texas Additional locations: Phoenix, Arizona | Minneapolis, Minnesota | Tampa, Florida | Hartford, Connecticut Date posted: 09/09/2026 Overtime status: Non-exempt Travel: No Share this job Facebook X LinkedIn Email 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 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 HBA Eligibility and Research Associate position is a member of the Post-Pay Eligibility & Research group within the Hospital Bill Audit (HBA) team and supports our auditors and audit process. The primary responsibility of the role is the perform pre-audit and post-audit analysis and research of claims and client contract information to determine eligibility of client claims for HBA audits and overpayment calculations This position is full-time Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7am - 6pm CST. It may be necessary, given the business need, to work occasional overtime. This will be on the job training and the hours during training will be during normal business hours. Primary Responsibilities: Utilize payer claim systems, where applicable, to review and analyze claims to verify eligibility for HBA audit including determination and updating of the payment methodology, exclusions, and non-covered charges in Optum systems Utilize payer claim systems to review contracts between clients and providers to identify contractual rates and guidelines to determine payment accuracy Determine overpayment calculation and refund due from provider Document outcome of payment analysis and research in appropriate Optum and client payer systems approve or reject claims for audit based on analysis/research Complete annual client compliance training and maintain access to client systems Research and respond to operational inquiries Provide feedback on ineligible claims where needed Other duties as assigned 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 of age OR older 1+ years of experience in medical claims processing/billing/collections and /or contract analysis Understanding of payment methodology and the ability to calculate correct payment amounts for claims including, but not limited to percent of charge, stop loss, DRG, per diem, case rate, etc. Understanding of relevant privacy regulations (e.g., HIPAA) Proficient computer skills including Microsoft Office suite; Microsoft Word (ability to create, copy, edit, save, and send documents), Microsoft Excel (ability to create, copy, edit, save, and send spreadsheets) and Microsoft Outlook (email and calendar management) Ability to work any of our 8-hour shift schedules during our normal business hours of 7:00am - 6:00pm CST, Monday - Friday 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: Requires attention to detail, organizational, problem solving and time management skills with flexibility to adjust to changing priorities Strong math skills; proficiency in the ability to apply proper payment methodologies and calculate payments Effective oral and written communication skills plus the ability to develop effective relationships with our internal and external customers Must be self-directed and able to prioritize own work; work with Specialists for more complex inquiries. Confidence in ability to make decisions and support those decisions; work with senior team members on more complex evaluations Ability to learn to interpret client-provider contracts and extract necessary information to support the audit process Ability to learn and apply applicable federal, state, and local compliance regulations *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 $18 - $32 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. Apply Internal apply Bookmark job Back to nav Benefits Our mission of helping people live healthier lives extends to our team members. Learn more about our range of benefits designed to help you live well. Life Resources and support to focus on what matters most to you, in every facet of your life. Emotional Education, tools and resources to help you reduce and manage stress, build resilience and more. Physical Health plans and other coverage to support wellness for you and your loved ones. Financial Benefits for today and to help you plan for the future, including your retirement. Learn more Back to nav Previous slide Being able to connect with so many people that all have the same goal in giving the best care possible is something truly special. Brooke G. Senior Pharmacy Technician At Optum, I receive the support, resources, and flexibility that I want so that I can be the best doctor possible while also finding personal and professional satisfaction. Dr. Conan T. Regional Chief of Primary Care We’re applying artificial intelligence to build something that can help people in their most distressed moments. The problems you work on here have an impact on someone’s life. Achala S. Senior Director and AI Architect Being able to connect with so many people that all have the same goal in giving the best care possible is something truly special. Brooke G. Senior Pharmacy Technician At Optum, I receive the support, resources, and flexibility that I want so that I can be the best doctor possible while also finding personal and professional satisfaction. Dr. Conan T. Regional Chief of Primary Care We’re applying artificial intelligence to build something that can help people in their most distressed moments. The problems you work on here have an impact on someone’s life. Achala S. Senior Director and AI Architect Being able to connect with so many people that all have the same goal in giving the best care possible is something truly special. Brooke G. Senior Pharmacy Technician Next slide Go to slide 1 Go to slide 2 Go to slide 3 Back to nav We’re honored to be recognized for our exceptional work culture Back to nav Discover our family of businesses See how we’re structured to help build a modern, high-performing health system. Learn more Explore our hiring process Learn what to expect when you pursue an opportunity with us. Learn more How we’re transforming care Find out how we’re making care smarter and more personalized. 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