Claims Representative Associate

Optum India; Dadri; On-site; INR 350,000 - 620,000; Full time

Job summary

Optum India is seeking a claims processing professional to accurately process and complete medical claims and route non-automatically adjudicated claims within turnaround standards. The role requires understanding plan concepts like deductible, coinsurance and copay, and adherence to company policies.

Candidates should demonstrate strong MS Office skills, analytical ability, and excellent communication. Night shifts may be required as part of the schedule to support global healthcare operations.

Qualifications

• Graduation (BTECH / BE / MBA / B pharm / M pharm are not eligible to apply).
• Working knowledge of MS Office.
• Result-oriented and goal-driven.
• Verbal and written communication skills (strong).
• Proven analytical ability with research, decision-making and interpersonal skills.
• Ability to accept constructive criticism and grow professionally.
• Critical thinking abilities.
• Ability to multi-task across multiple products and benefits.
• Willingness to work night shifts.

Responsibilities

• Accurate processing and completion of medical claims.
• Process claims that route out of automatic adjudication, within current turnaround standards.
• Demonstrate proficiency in product lines applicable to processing unit.
• Understand and apply plan concepts: Deductible, Coinsurance, Copay, Out-of-pocket, State variations.
• Comply with all applicable Company policies, procedures, and business directives, changes including those relating to work location, team assignments, work schedules, and flexible work arrangements

Skills

MS Office

Communication skills

Analytical ability

Multi-tasking

Night shifts readiness

Education

Graduation

Tools

MS Office

Job description

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

• Accurate processing and completion of medical claims
• Process claims that route out of automatic adjudication, within current turnaround standards
• Demonstrate proficiency in product lines applicable to processing unit
• Understand and apply plan concepts: Deductible, Coinsurance, Copay, Out-of-pocket, State variations
• Comply with all applicable Company policies, procedures, and business directives, changes including those relating to work location, team assignments, work schedules, and flexible work arrangements
  

Required Qualifications

• Graduation (BTECH / BE / MBA / B pharm / M pharm are not eligible to apply)
• Working knowledge of MS Office
• Result-oriented and goal-driven
• Demonstrated solid verbal and written communication skills
• Proven excellent communication skills written and verbal
• Proven analytical ability: Research skills combined with effective decision-making and superior interpersonal skills
• Proven ability to accept constructive criticism with being coached and growing as a professional
• Proven critical thinking abilities
• Proven ability to accept constructive criticism with being coached and growing as a professional
• Proven ability to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each product
• Proven ability to remain focused and productive each day though tasks may be repetitive
• Good typing speed (English) and accuracy
• Willing to work night shifts
  

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.