JOB TITLE : HEALTHCARE CLAIMS REPRESENTATIVES
WHO WE ARE :
Optum is a part of the UnitedHealth Group, a Fortune 5 company, serving 125 million individual consumers.
We are a diverse company with over 189,000 employees worldwide and over 14,000 employees in the Philippines
We are a leader in nearly every aspect of today’s health care landscape
We leverage on having the largest single proprietary network of physicians, hospitals, health facilities, and caregivers in the United States.
At Optum, we believe that what makes you special can inspire your life’s best work.
Welcome to one of the toughest and most fulfilling ways to help people, including you. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement.
Join us and start doing your life’s best work.SM
Join us today and unlock a world of rewards and benefits for performance, career growth, work-life balance and the opportunity to pursue your passion.
WHAT WE OFFER :
Market Competitive Pay Levels
Medical Plan (HMO) from Day 1 of employment
Dental, Medical, and Optical Reimbursements
Life and Disability Insurance
Paid Time-Off Benefits
Sick Leave Conversion
Tuition Fee Reimbursement
Employee Assistance Program (EAP)
Annual Performance Based Merit Increases
Training and Staff Development
Employee Referral Program
Employee Volunteerism Opportunity
All Mandatory Statutory Benefits
ROLE AND RESPONSIBILITIES :
Provide expertise claims support by reviewing, researching, investigating, negotiating and resolving all types of claims as well as recovery and resolution for health plans, commercial customers and government entities
Analyze and identify trends and provides reports as necessary
Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance
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 regards 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 :
Completed at least 2nd year in college
At least 6 months of Healthcare BPO experience handling Claims, Benefits, and Eligibility
Stable work experience
Moderate proficiency with Windows PC applications, which includes the ability to learn new and complex computer system applications
Ability to navigate a computer while on the phone
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
Available to work 40 hours per week anytime within the operating hours of the site