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Claims Associate

Work from home Full-time role Hiring

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 to start Caring. Connecting. Growing together.

Primary Responsibilities

  • Be able to understand and apply plan concepts to include:
    • Deductible
    • Coinsurance
    • Copay
    • Out of Pocket
  • Recognize issues related to variable deductible, coordination of benefits; carve-out alternate benefits
  • Participate in Special projects as required
  • Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so

Required Qualifications

  • Experience in US Healthcare
  • Good keyboard skills with average typing speed of around 35 - 40 WPM
  • Good knowledge of MS - Word & MS - Excel
  • Proven attention to detail
  • Proven quality focused
  • Proven written and verbal communication skills
  • Proven organizational skills
  • Proven team player
  • Proven ability to work without close supervision
  • Proven good analytical skills. Candidate should have the ability to understand the mistakes and correct the same
  • Proven good comprehension skills
  • Good understanding of English and ability to write emails in English
  • Open for night shifts

Preferred Qualifications

  • Understanding of claim life cycle 
  • Understanding of Claims and Auto Adjudication process

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.

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