Claims Representative

1 week ago


Hyderabad, India Optum Full time

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing **your life's best work.(sm)**

It's that time, isn't it? You're ready for the next step forward and an opportunity to build on your skills. And it just so happens that there's never been a better time to get on the team at UnitedHealth Group. We've built one of the world's most effective and respected claims processing teams. And that's where you come in. We'll look to you to maintain our reputation for service, accuracy and providing a positive claims experience. We'll back you with the great training, support and opportunities you'd expect from a Fortune 5 leader.

**Primary Responsibilities**:

- Provide expertise or general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims
- Analyze and identify trends and provide reports as necessary
- 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 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

This is a challenging role that takes an ability to thoroughly review, analyze and research complex healthcare claims in order to identify discrepancies, verify pricing, confirm prior authorizations and process them for payment. 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 support timely processing of the member's claim.

**Required Qualifications**:

- An education level of at least a high school diploma or GED OR equivalent years of work experience
- 1+ years of experience in a related environment (i.e. office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools
- Ability to have accuracy which will support timely processing of the member's claim

**Preferred Qualification**:

- 1+ years experience processing medical, dental, prescription or mental health claims

Making claims a positive experience for our members can drive your sense of impact and purpose. Join us as we improve the lives of millions. Learn more about how you can start doing **your life's best work.(sm)**

**Careers with Optum. **Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do **your life's best work.(sm)



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