Claims Representative - San Juan, PR

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 in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.

Primary Responsibilities:

Authorizes the appropriate payment or refers claims to investigators for further review

Conducts data entry and claims processing/issues

Responsible for 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

*** ENGLISH PROFICIENT ASSESSMENT WILL BE REQUIRED AFTER APPLICATION ***

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.

Required Qualifications:

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

Ability 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)

Preferred Qualifications:

Experience in medical billing or claims

Healthcare experience

At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.

UnitedHealth Group and its affiliated brands are an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.