About this role
About the Role Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. This role focuses on providing expertise in claims support and recovery for health plans, commercial customers and government entities, to help improve health outcomes and ensure compliance. What You'll Do
- Provide expertise claims support by reviewing, researching, investigating, negotiating and resolving all types of claims as well as recovery and resolution for health plans, commercial customers and government entities.
- Analyze and identify trends and provide reports as necessary.
- Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance.
- Comply with the terms and conditions of the employment contract, company policies and procedures, and any directives related to transfers, reassignments, changes in teams or work shifts, flexibility of work benefits, alternative work arrangements, and other decisions that may arise due to changing business environment.
- Understand and adapt to evolving policies that the company may adopt, vary or rescind at its discretion. What We're Looking For
- College graduate of any 4-year course.
- 4+ years of experience in claims recovery and resolution.
- Proficiency with computer and Windows PC applications, including the ability to learn new and complex computer system applications.
- Proven ability to multi-task and understand multiple products and multiple levels of benefits within each product.