Healthcare Admin Representative - Determination Letters - San Juan, PR
About The Position
Optum is seeking a Healthcare Admin Representative to prepare determination letters in San Juan, Puerto Rico. The role drafts and prepares Notice of Action and Notice of Extension letters in compliance with applicable state and federal regulations. The representative customizes letters for government and commercial clients, maintains regulatory, client, and accreditation standards, and selects appropriate letter templates based on case details. Other duties may apply. An English proficiency assessment is required after application. The position offers performance recognition, clear direction, and development opportunities for other roles.
Requirements
- At least 1 year of experience in a healthcare environment.
- Experience creating, editing, and saving documents in Microsoft Word and spreadsheets in Microsoft Excel.
- Experience working with a PC and Windows applications.
- Professional English proficiency; an English proficiency assessment is required after application.
- Willingness or ability to work 40 hours per week during standard business operating hours, Monday through Friday, between 8 a.m. and 8 p.m.
- Ability to work occasional overtime on weekends and holidays when business needs require.
- Ability to undergo cross-training in accordance with business needs.
Nice To Haves
- Experience in a call center setting.
- Professional experience in a clinical, clerical, or administrative support-related role.
- Experience working within the healthcare industry.
- Working knowledge of medical terminology.
Responsibilities
- Draft and prepare Notice of Action and Notice of Extension letters in compliance with applicable state and federal regulations.
- Customize letter content to meet government and commercial client requirements, ensuring clarity, accuracy, and consistency.
- Maintain adherence to regulatory, client, and accreditation standards in written communications.
- Use product and service knowledge to identify and apply the correct letter templates based on individual case details.
- Undertake other duties as applicable.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
