Recovery Resolutions 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. The Recovery Resolutions Representative supports the two parts of the Prospective Investigations process by identifying and keying specific detail from the medical records and determine if the claims proceed with a payment. Incumbents are responsible for dealing professionally and ethically safeguarding confidential information, adhering to UHG’s Principles of Integrity and Compliance. This position is critical to the success of the Investigative teams and their ability to meet required internal and mandated turn-around times. 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 within a Healthcare environment using the computer as the primary instrument to perform job duties
- Production environment experience
- Working experience with Microsoft Tools: Microsoft Teams (join meetings and trainings), Microsoft Power Point (prepare presentations), Microsoft Word (creating memos, writing), Microsoft Outlook (setting calendar appointments, email) and Microsoft Excel (creating spreadsheets, filtering, navigating reports)
- Available to work (40 hours/week) Monday - Friday. Flexible to work any of our 8-hour shift schedules during our normal business hours of (6:00am to 6:00pm EST). It may be necessary, given the business need, to occasionally work mandatory overtime, holidays or weekends
- English proficiency
- Driver’s License and access to reliable transportation
Nice To Haves
- Coding experience
- Managed care experience
- Claims processing experience
- Medical records familiarity
Responsibilities
- Data enter key detail from the medical records and claim platform into an online communication
- Meet required productivity and quality metrics
- Adherence to state and federal compliance policies and contract compliance
- Assist the prospective team with special projects and reporting
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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
