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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.This position is full time Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8am – 4:30pm. It may be necessary, given the business need, to work occasional overtime and flexibility to work evenings, weekends, and holidays as needed. Our office is located at 12921 S Vista Station Blvd, Ste 200, Draper, UT 84020.We offer weeks of on-the-job training. The hours of training will be aligned with your schedule.Primary Responsibilities:
Answer incoming calls promptly, professionally, providing exceptional customer service to all callers
Verify member eligibility and coverage details to ensure accurate claim processing
Process health insurance related claims accurately and efficiently, following company protocols and guidelines
Review and analyze claim documentation, including medical bills, invoices, and supporting documentation
Identify and resolve claim discrepancies, errors, or missing information in a timely manner
Assist members with understanding their claims status
Communicate claims decisions to members professionally and courteously
Address member inquiries and resolve issues related to claims, eligibility, and coverage discrepancies
Maintain detailed and accurate records of all calls, interactions, and claims transactions in the company database
Adhere to all privacy regulations and maintain confidentiality of member information
Stay informed and up to date on health insurance policies, procedures, and regulations to provide accurate information to all callers
Participate in ongoing training and development programs to enhance knowledge and skills related to health insurance claims process and customer service
Contribute to a positive and supportive team environment, demonstrating professionalism and integrity in all interactions
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 OR equivalent work experience
Must be 18 years of age OR older
Experience in a call center environment preferably in the healthcare of insurance industry
Strong customer service skills with the ability to effectively communicate and empathize with callers
Excellent problem-solving skills and attention to detail
Proficiency in using computer systems and navigating multiple software applications simultaneously
Ability to work efficiently in a fast-paced environment and manage multiple tasks effectively
Flexibility to work evenings, weekends, and holidays as needed
Ability to work Monday-Friday, 8am – 4:30pm
Preferred Qualifications:
Knowledge of health insurance terminology claims processing procedures and regulatory requirements is a plus
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.Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment .#RPO #RED
