Healthcare Claims Resolution Specialist

Optum Philippines; Makati; On-site; PHP 500,000 - 700,000; Full time

Job summary

Optum Philippines is seeking an experienced claims professional to provide expert support in reviewing, researching, negotiating, and resolving complex health plan claims. You will analyze trends and generate reports while ensuring compliance with policies and contracts.

The role requires adaptability to policy changes and various work arrangements. Ideal candidates have 4+ years in claims recovery and resolution and strong proficiency with Windows PC applications.

Qualifications

• College graduate of any 4 year course.
• 4+ years of experience in claims recovery and resolution.
• Proficiency with computer and Windows PC applications.
• Proven ability to multitask across multiple products and benefits.

Responsibilities

• Provide expertise claims support by reviewing, researching, negotiating and resolving all types of claims.
• Analyze and identify trends and provide reports.
• Ensure adherence to applicable compliance policies and contract terms.
• Remain adaptable to policy changes and work location arrangements.

Skills

Claims processing

Data analysis

Windows proficiency

multitasking

Education

4-year college degree

Tools

Windows OS

Job description

Optum Philippines is seeking an experienced claims professional to provide expert support in reviewing, researching, negotiating, and resolving complex health plan claims. You will analyze trends and generate reports while ensuring compliance with policies and contracts.

The role requires adaptability to policy changes and various work arrangements. Ideal candidates have 4+ years in claims recovery and resolution and strong proficiency with Windows PC applications.