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Associate Claims Representative
Associate Claims RepresentativeTexas Staffing • Dallas, TX, US
Associate Claims Representative

Associate Claims Representative

Texas Staffing • Dallas, TX, US
1 day ago
Job type
  • Full-time
Job description

Optum Remote Position

This position is national remote. You'll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges. 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, 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. If putting a smile on someone's face puts one on yours, you belong on our team. Here at Optum and UnitedHealth Group, we've brought together teams of incredibly compassionate and absolutely positive people to help serve our members when they call us with questions regarding their health care coverage, eligibility, or reimbursement. Your helpful personality combined with our support, training, and development will ensure your success. This is no small opportunity. This is where you can bring your compassion for others while building a career. This role is equally challenging and rewarding. You'll be called on to research complex issues across multiple databases. It requires fluency in computer navigation and toggling while you confidently and compassionately engage in dialogue with the caller. Be assured that our training will provide you with knowledge of the various products, plans, and levels of benefits available to members and you'll soon find yourself creating positive experiences and earning the gratitude of callers on an hourly basis. This position is full time, Monday - Friday. Employees are required to have flexibility to work any of our shift schedules during our normal business hours of 8 : 00 am - 5 : 00 pm CST. It may be necessary, given the business need, to work occasional overtime. We offer 4 weeks of paid on-the-job training. The hours of training will be aligned with your schedule during normal business hours.

Primary Responsibilities :

  • Making outbound calls to care providers and minimal inbound calls
  • Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems
  • Contact care providers (hospitals) on behalf of the customer to assist with claims related issues or concerns
  • Research complex issues across multiple databases and work with support resources to resolve customer issues and / or partner with others to resolve escalated issues

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications :

  • High School Diploma / GED
  • Must be 18 years of age or older
  • 1+ years of customer service experience
  • Administrative experience
  • Experience in a fast-paced or production environment
  • Experience with Microsoft Word (ability to create and edit spreadsheets)
  • Experience with Microsoft Excel (ability to create, edit, filter, and sort through spreadsheets)
  • Experience with Microsoft Outlook (ability to send / receive emails and calendar invites)
  • Proficiency with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
  • Ability to work any of our shift schedules during our normal business hours of 8 : 00 am - 5 : 00 pm CST from Monday - Friday. It may be necessary, given the business need, to work occasional overtime.
  • Preferred Qualifications :

  • Experience with processing medical, dental, or prescription claims
  • Familiarity with UB04's
  • Understand and maintain HIPAA confidentiality and privacy standards when completing assigned work
  • Telecommuting Requirements :

  • Ability to keep all company sensitive documents secure (if applicable)
  • Required to have a dedicated work area established that is separated from other living areas and provides information privacy
  • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
  • Soft Skills :

  • Demonstrated ability to listen skillfully, collect relevant information, build rapport, and respond to customers in a compassionate manner
  • Detail-oriented - maintain a high level of quality
  • Strong telephone skills
  • Proficient conflict management skills to resolve issues in a stressful situation
  • All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution (all benefits are subject to eligibility requirements). The hourly pay for this role will range from $16.00 - $27.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

    Application Deadline : This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

    At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone deserves the opportunity to live their healthiest life. UnitedHealth Group is an Equal Employment Opportunity employer and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status.

    UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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    Claim Representative • Dallas, TX, US

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