Claims Associate

5 days ago

Hyderabad India Optum Full time

Job Description

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:

- Claims adjudication/Adjustments/Rework by reviewing the policies, researching, investigating, negotiating, processing, and adjusting claims
- Consistently meet established productivity, schedule adherence and quality standards
- 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

This is a challenging role that takes an ability to thoroughly review, analyze and research claims to verify pricing, review prior authorizations and process them for payment as per the policies.

You'll need to be comfortable navigating across various computer systems to locate critical information. Attention to detail is critical to ensure accuracy, which will impact the timely processing of the claims.

Required Qualifications:

- Graduate in any discipline except BTech/MCA
- Proficiency with Windows PC applications, which includes the ability to navigate multiple programs and learn new and complex computer system applications

Preferred Qualifications:

- Freshers/ experience in health care, processing medical, dental, prescription or mental health claims
- Should be flexible to work if any shift
- Work form office

#njp

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