Impactful Healthcare Claims Specialist

Optum, a UnitedHealth Group Company; Makati; On-site; PHP 600,000 - 900,000; Full time

Job summary

Optum Global Solutions (Philippines) Inc. is seeking a Claims Recovery Specialist to review, negotiate and resolve diverse health plan claims while ensuring compliance with policies and contracts. The role requires strong analytical abilities and the capacity to manage multiple products and benefits.

You will work in a dynamic environment with a focus on accuracy and timely resolution. The ideal candidate has 4+ years of claims recovery experience, proficiency in Windows PC applications, and the

Qualifications

• 4+ years of experience in claims recovery and resolution

Responsibilities

• Review, research, investigate, negotiate and resolve all types of claims for health plans, commercial customers and government entities
• Analyze trends and prepare reports as needed
• Ensure adherence to applicable compliance policies and contract terms
• Follow employment contract terms and company policies, including possible transfers or changes in work location or shifts

Skills

Claims recovery

Analytical skills

Windows PC applications

Multi-tasking

Education

4‑year college degree

Tools

Windows

Job description

Optum Global Solutions (Philippines) Inc. is seeking a Claims Recovery Specialist to review, negotiate and resolve diverse health plan claims while ensuring compliance with policies and contracts. The role requires strong analytical abilities and the capacity to manage multiple products and benefits.

You will work in a dynamic environment with a focus on accuracy and timely resolution. The ideal candidate has 4+ years of claims recovery experience, proficiency in Windows PC applications, and the