Claims Representative - Remote in Pacific Time Zone

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.

This position is full time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 6:00 am – 8:00 pm. It may be necessary, given the business need, to work occasional overtime.

We offer 2-4 weeks of paid training. The hours during training will be 8:00 am to 5:00 pm, Monday - Friday.

If you are located in Pacific Time Zone, you will have the flexibility to work remotely* as you take on some tough challenges.

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 • Produce 400 claims a day (or avg by the end of the week)

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 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: • High School Diploma/GED OR equivalent years of work experience • 18 years or older • 1 year of experience in a related environment (i.e. office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools • An education level of at least a high school diploma or GED OR equivalent years of work experience • Proficiency with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications • Ability to work any of our 8-hour shift schedules during our normal business hours Monday to Friday of 6:00 am – 8:00 pm. It may be necessary, given the business need, to work occasional overtime.

Preferred Qualifications: • 1 year experience processing medical, dental, prescription or mental health claims

Telecommuting Requirements: • Reside within Pacific Time Zone • Ability to keep all company sensitive documents secure (if applicable) • Required to have a dedicated work area established that is separated from other living areas and provides information privacy. • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service. • All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

California, Nevada OR Washington. Residents Only: The hourly range for this is $16.54 - $32.55 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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