Healthcare Claims Representative
Optum, a UnitedHealth Group company
Quezon City, PH
5d ago
source : Bossjob

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
  • Retirement Plan
  • 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
  • Employee Recognition
  • 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
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