The Claims Representative Associate is responsible for processing medical claims accurately, understanding plan concepts, and maintaining compliance with company policies while demonstrating good communication and analytical skills.
Requisition Number: 2366232
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.
Primary Responsibilities:
Required Qualifications:
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.
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.
Primary Responsibilities:
- Accurate processing and completion of medical claims
- Process claims that route out of automatic adjudication, within current turnaround standards
- Demonstrate proficiency in product lines applicable to processing unit
- Understand and apply plan concepts: Deductible, Coinsurance, Copay, Out-of-pocket, State variations
- Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regard to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so
Required Qualifications:
- Graduation (BTECH / BE / MBA / B pharm / M pharm are not eligible to apply)
- Good communication skills written and verbal
- Good typing speed (English) and accuracy
- Proven result-oriented and goal-driven
- Analytical ability: Research skills combined with effective decision-making and superior interpersonal skills
- Solid verbal and written communication skills
- Ability to accept constructive criticism with being coached and growing as a professional
- Critical thinking abilities
- Ability to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each product
- Ability to remain focused and productive each day though tasks may be repetitive
- Willing to work night shifts
- Working Knowledge of MS Office
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.
Optum Pune, Maharashtra, IND Office
Pune, India, India
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