Claims Representative - San Juan, PR
About The Position
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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Requirements
- 1+ years of experience in a production environment
- Proficient in MS Office with solid computer skills (e.g. multiple systems experience, keyboarding skills, Microsoft word, Power Point)
- Proficient in verbal and written English skills
- Willing or able to work 40 hours / week during standard business operating hours Monday - Friday from 7am - 7pm AST (It may be necessary, given the business need, to work occasional overtime on weekends and holidays)
- ENGLISH PROFICIENT ASSESSMENT WILL BE REQUIRED AFTER APPLICATION
Nice To Haves
- Experience in medical billing or claims
- Healthcare experience
Responsibilities
- Authorizes the appropriate payment or refers claims to investigators for further review
- Conducts data entry and claims processing/issues
- Handling issues within turnaround standards
- Ability to handle most claim types / cases / issues that are submitted to the team you are supporting
- Ability handle escalations as needed
- Ability to work multiple functions and applications in a day as needed
- Communicate any changes in trending of inventory, volumes, and quality remediation
- Complete required individual development courses / training
- Meet and maintain minimum quality and productivity standards
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
Number of Employees
5,001-10,000 employees
