claims service representative

Farm Bureau Financial Services

<div>Do you thrive in a work environment where you must multi-task and have strong organizational skills? Are you a go-getter with high initiative and a positive attitude? Do you have past MedPay/PIP experience or a background in the medical field with a strong customer service mindset? If so, this Claims Service Representative opportunity could be a great fit for you!
Who We Are: With Farm Bureau Financial Services, our client/members can feel confident knowing their family, home, cars and other property are protected. We value a culture where integrity, teamwork, passion, service, leadership and accountability are at the heart of every decision we make and every action we take. We&rsquo;re proud of our more than 80-year commitment to protecting the livelihoods and futures of our client/members and creating an atmosphere where our employees thrive.
What You&rsquo;ll Do: As a Claim Service Representative &ndash; MedPay/PIP, you will review, investigate, and evaluate medical and Personal Injury Protection (PIP) claims payments. You will project a positive image of Farm Bureau by fairly and efficiently negotiating and settling claims with all customers. You will also assure claims are settled in accordance with regulations and policy language by reviewing medical bills submitted for accuracy, necessity and reasonableness. You will be responsible for adjusting or denying claims, considering deductible amounts and policy limits. You will take recorded statements from claimants and witnesses, as well as work with defense and plaintiff attorneys to settle claims. It is your responsibility to ensure only justifiable claims are paid by the company by reviewing the policy and external medical records to determine applicable coverage.
What It Takes to Join Our Team:<ul><li> Associates degree or equivalent plus 1-3 years of experience. Prior Med Pay/PIP handling OR Medical claims experience is preferred.</li><li> Strong negotiation and communication skills are required in order to explain your decisions to insureds, claimants, and agents.</li><li> It will be necessary to maintain a professional and productive relationships with agents, policyholders, claimants, doctors, attorneys and others, to bring credit to the claims department and company.</li><li> Ability to keep a service-oriented attitude at all times.</li><li> Strong written communication skills are important to prepare running documentation and written reports.</li><li> Ability to spend up to 50% of your day on the telephone, while spending the majority of your time at a desk.</li><li> You will be expected to learn and keep up to date on Unfair Claims Practice Act, policy knowledge, and other governmental or company rules and regulations.</li><li> The ability to exercise independent judgment and arrive at decisions through sound, logical reasoning in order to handle more complex claims is required.</li><li> Ability to work from our office located in West Des Moines, IA.</li></ul>
What We Offer You: When you&rsquo;re on our team, you get more than a great paycheck. You&rsquo;ll hear about career development and educational opportunities. We offer an enhanced 401K with a match, low cost health, dental, and vision benefits, and life and disability insurance options. We also offer paid time off, including holidays and volunteer time, and teams who know how to have fun. Add to that an onsite wellness facility with fitness classes and programs, a daycare center, a cafeteria, and for many positions, even consideration for a hybrid work arrangement. Farm Bureau....where the grass really IS greener!
Work Authorization/Sponsorship: At this time, we are not considering candidates that need any type of immigration sponsorship now or in the future, such as additional or permanent work authorization. Applicants must be currently authorized to work in the United States on a full-time, permanent basis. We are not able to sponsor now or in the future, or take over sponsorship of, an employment visa or work authorization for this role. For example, we are not considering candidates with OPT status.</div>

Claims Service Representative- Claims Medical Team

Cigna Healthcare

<div>
 The Customer Service Associate Representative provides support to participants, clients, and providers by answering inquiries related to group health benefits and claims payments. The role also includes researching claims, documenting interactions, and assisting team members as needed.
 
 
 
 Essential Job Functions
 
 
 
 <ul>
 <li>
 Answer telephone calls from plan participants, group contacts, and providers regarding benefits and claims.
 </li>
 <li>
 Provide clear, accurate, and timely responses to information requests.
 </li>
 <li>
 Document all calls in Chronolog by summarizing key points of each conversation.
 </li>
 <li>
 Return messages from designated voicemail boxes.
 </li>
 <li>
 Read, interpret, and apply plan documents, new amendments, and updates for multiple clients.
 </li>
 <li>
 Meet with clients as needed to assist with questions about their health benefit plans.
 </li>
 <li>
 Support team members and cross‑functional partners as requested.
 </li>
 <li>
 Log faxed claims and enter fax information into Chronolog.
 </li>
 <li>
 Return misdirected claims to the appropriate provider.
 </li>
 <li>
 Assist members with navigating the website.
 </li>
 <li>
 Meet or exceed company standards for quality and production.
 </li>
 <li>
 Maintain punctual and reliable attendance.
 </li>
 <li>
 Support claim information research and identification.
 </li>
 <li>
 Assist with provider record maintenance tasks.
 </li>
 <li>
 Index claims and correspondence batches.
 </li>
 <li>
 Complete responsibilities assigned for specific client groups.
 </li>
 <li>
 Aid in employee training and cross‑training.
 </li>
 <li>
 Research and prepare refund documentation.
 
 
 </li>
 </ul>
 Quality Assurance Measurements
 
 
 <ul>
 <li>
 Consistently meet or exceed company standards for production, quality, and audit performance.
 
 
 </li>
 </ul>
 Minimum Education
 
 
 <ul>
 <li>
 High school diploma or GED required.
 
 
 </li>
 </ul>
 
 Minimum Experience
 
 
 
 <ul>
 <li>
 Basic computer and customer service experience.
 </li>
 <li>
 Excellent verbal and written communication skills.
 </li>
 <li>
 Proficiency with PC tools including Windows, Word, and Adobe Acrobat; ability to learn new software.
 </li>
 <li>
 Minimum typing speed of 45 wpm.
 </li>
 <li>
 Strong listening skills and attention to detail.
 </li>
 <li>
 Basic mathematical competency.
 </li>
 <li>
 High interpersonal skills and the ability to work collaboratively.
 </li>
 <li>
 Ability to organize and recall large amounts of detailed information.
 </li>
 <li>
 Capability to read, analyze, and interpret benefit plans, insurance documents, and regulations.
 </li>
 <li>
 Professional attitude with the ability to project a positive image in all work environments.
 </li>
 <li>
 Commitment to privacy and confidentiality standards.
 </li>
 <li>
 Flexibility to work under pressure and meet deadlines.
 </li>
 <li>
 Strong problem‑solving abilities with professionalism and patience.
 
 
 </li>
 </ul>
 
 About Allegiance By Cigna Healthcare
 
 
 
 
 Since 1981, Allegiance by Cigna Healthcare has specialized in administering medical benefits, including claims processing, customer service, utilization management, and case management. With a high‑touch approach to member and client service, Allegiance supports some of the nation&rsquo;s most innovative health benefit strategies.
 
 
 
 If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
 
 
 
 About Cigna Healthcare
 
 
 
 Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.
 
 
 
 Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
 
 
 
 
 If you need a reasonable accommodation to complete the online application process, please email
 
 
 
 seeyourself@thecignagroup.com
 
 
 
 for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.
 
 
 
 
 The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
 
 
 
 
 Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
 
</div>

Customer Service Representative - Cigna Healthcare - Remote

HUB International

<div>About SPG:
Specialty Program Group (SPG) is the wholesale &amp; MGA division of HUB International (5th Largest Global Broker). SPG acts in a holding company capacity acquiring best in class underwriting businesses to operate independently under discrete brands (portfolio companies).
Job Description:
The Claims Service Associate Summer Intern is a critical position supporting claims advocacy teams and clients in all phases of claims service. This position directly affects customer satisfaction and positively impacts the client retention goals of the organization.
Essential Duties and Responsibilities:
Quickly identifies the requirements of the incoming claims task and executes steps to complete the task with accuracy, empathy and speed. Tasks include:<ul><li>
Touchpoint client communications for claims (i.e. new claims intake calls, answer non-coverage client inquiries, provide claim updates, claim follow up calls)</li><li>
Maintains data and documentation in EPIC (i.e. claim number, claim status, payment information)</li><li>
Provides key stakeholders with claim updates</li><li>
Escalates coverage related calls or issues to Claims Advocates</li></ul>
Work Experience Requirements:<ul><li>
0&ndash;1 years' work experience</li><li>
Experience with Insurance Claims organization or Insurance Brokerage preferred</li></ul>
Education Requirements:<ul><li>
High school diploma required</li></ul>
Licensing or Certification Requirements:<ul><li>
Property &amp; Casualty license preferred &ndash; for state specific training (licensing preferred within the first 6 months of employment)</li></ul>
Hours/Duration:<ul><li>
18 hours/week</li><li>
12 weeks total</li></ul>
Salary Transparency:
Disclosure required under applicable law in California, Colorado, Illinois, Maryland, Minnesota, New York, New Jersey, and Washington states: The expected salary range for this position is $20/hr and will be impacted by factors such as the successful candidate&rsquo;s skills, experience and working location, as well as the specific position&rsquo;s business line, scope and level. HUB International is proud to offer comprehensive benefit and total compensation packages: health/dental/vision/life/disability insurance, FSA, HSA and 401(k) accounts, paid-time-off benefits such as vacation, sick, and personal days, and eligible bonuses, equity and commissions for some positions.
#SPG
Department Account Management &amp; Service
Required Experience: Less than 1 year of relevant experience
Required Travel: No Travel Required
Required Education: High school or equivalent
HUB International Limited is an equal opportunity employer that does not discriminate on the basis of race/ethnicity, national origin, religion, age, color, sex, sexual orientation, gender identity, disability or veteran's status, or any other characteristic protected by local, state or federal laws, rules or regulations.
E-Verify Program
We endeavor to make this website accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the recruiting team HUBRecruiting@hubinternational.com. This contact information is for accommodation requests only; do not use this contact information to inquire about the status of applications.</div>

Claims Service Associate - Summer Intern

GEICO

<div>At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities.
Every day we honor our iconic brand by offering quality coverage to millions of customers and being there when they need us most. We thrive through relentless innovation to exceed our customers&rsquo; expectations while making a real impact for our company through our shared purpose.
When you join our company, we want you to feel valued, supported and proud to work here. That&rsquo;s why we offer The GEICO Pledge: Great Company, Great Culture, Great Rewards and Great Careers.<h2 class="jobSectionHeader">
Claims Service Specialist 
Salary: $25.81 per hour / $52,000 annually</h2><h2 class="jobSectionHeader">
This is an in-office position</h2><div>
At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities. 
Every day we honor our iconic brand by offering quality coverage to millions of customers and being there when they need us most. We thrive through relentless innovation to exceed our customers&rsquo; expectations while making a real impact for our company through our shared purpose. 
 
When you join our company, we want you to feel valued, supported and proud to work here. That&rsquo;s why we offer The GEICO Pledge: Great Company, Great Culture, Great Rewards and Great Careers. 
 
Claim your career growth as a Claims Service Specialist at GEICO&rsquo;s Melville, NY office and be a part of one of the fastest-growing auto insurers in the United States! If you are motivated, all about solutions, and empathetic to the needs of customers, come grow a fulfilling career with us! 
 
Through our paid, industry-leading training, you will learn the ins and outs of the claims process and be ready to assist our policyholders when they need us the most &ndash; during an accident. As a Claims Service Specialist, you will collect facts about the accident, investigate claim details, and collect statements from involved parties. Our policyholders will count on your patience, support, and attention to detail to get them back on the road as quickly as possible. GEICO will also give you the space and grace to explore your abilities and learn new ones. So if you are ready to start growing your career, let&rsquo;s talk! 
 
Many associates see a base salary increase of 10% within their first year as a Claims Specialist. Top associates can see increases up to 15%! 
 
Qualifications &amp; Skill:<ul><li>
Candidate must have the ability to commute to our Melville NY location.</li><li>
Experience providing outstanding customer service by showcasing expertise, fostering trust and growing customer satisfaction</li><li>
Solid computer multitasking skills</li><li>
Ability to work comfortably and grow in a fast-paced, high-volume call center environment</li><li>
Minimum of high school diploma or equivalent</li><li>
Eagerness to explore new skills and openness to different career paths</li></ul>
#geico200</div> 
Annual Salary
$23.91 - $37.65
The above annual salary range is a general guideline. Multiple factors are taken into consideration to arrive at the final hourly rate/ annual salary to be offered to the selected candidate. Factors include, but are not limited to, the scope and responsibilities of the role, the selected candidate&rsquo;s work experience, education and training, the work location as well as market and business considerations. 

At this time, GEICO will not sponsor a new applicant for employment authorization for this position. 
The GEICO Pledge:
Great Company: At GEICO, we help our customers through life&rsquo;s twists and turns. Our mission is to protect people when they need it most and we&rsquo;re constantly evolving to stay ahead of their needs.
We&rsquo;re an iconic brand that thrives on innovation, exceeding our customers&rsquo; expectations and enabling our collective success. From day one, you&rsquo;ll take on exciting challenges that help you grow and collaborate with dynamic teams who want to make a positive impact on people&rsquo;s lives.
Great Careers: We offer a career where you can learn, grow, and thrive through personalized development programs, created with your career &ndash; and your potential &ndash; in mind. You&rsquo;ll have access to industry leading training, certification assistance, career mentorship and coaching with supportive leaders at all levels.
Great Culture: We foster an inclusive culture of shared success, rooted in integrity, a bias for action and a winning mindset. Grounded by our core values, we have an an established culture of caring, inclusion, and belonging, that values different perspectives. Our teams are led by dynamic, multi-faceted teams led by supportive leaders, driven by performance excellence and unified under a shared purpose.
As part of our culture, we also offer employee engagement and recognition programs that reward the positive impact our work makes on the lives of our customers.
Great Rewards: We offer compensation and benefits built to enhance your physical well-being, mental and emotional health and financial future.<ul><li>
Comprehensive Total Rewards program that offers personalized coverage tailor-made for you and your family&rsquo;s overall well-being.</li><li>
Financial benefits including market-competitive compensation; a 401K savings plan vested from day one that offers a 6% match; performance and recognition-based incentives; and tuition assistance.</li><li>
Access to additional benefits like mental healthcare as well as fertility and adoption assistance.</li><li>
Supports flexibility- We provide workplace flexibility as well as our GEICO Flex program, which offers the ability to work from anywhere in the US for up to four weeks per year.</li></ul>
The equal employment opportunity policy of the GEICO Companies provides for a fair and equal employment opportunity for all associates and job applicants regardless of race, color, religious creed, national origin, ancestry, age, gender, pregnancy, sexual orientation, gender identity, marital status, familial status, disability or genetic information, in compliance with applicable federal, state and local law. GEICO hires and promotes individuals solely on the basis of their qualifications for the job to be filled.
GEICO reasonably accommodates qualified individuals with disabilities to enable them to receive equal employment opportunity and/or perform the essential functions of the job, unless the accommodation would impose an undue hardship to the Company. This applies to all applicants and associates. GEICO also provides a work environment in which each associate is able to be productive and work to the best of their ability. We do not condone or tolerate an atmosphere of intimidation or harassment. We expect and require the cooperation of all associates in maintaining an atmosphere free from discrimination and harassment with mutual respect by and for all associates and applicants.</div>

Claims Service Specialist

<div>At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities.
Every day we honor our iconic brand by offering quality coverage to millions of customers and being there when they need us most. We thrive through relentless innovation to exceed our customers&rsquo; expectations while making a real impact for our company through our shared purpose.
When you join our company, we want you to feel valued, supported and proud to work here. That&rsquo;s why we offer The GEICO Pledge: Great Company, Great Culture, Great Rewards and Great Careers.
Claims Service Specialist &ndash; Tampa, Florida 
Salary: $28.29 - $34.24 per hour / $57,000 - $69,000 annually 
Claim your career growth as a Claims Service Specialist at GEICO&rsquo;s Tampa, Florida office and be a part of one of the fastest-growing auto insurers in the United States! If you are motivated, all about solutions, and empathetic to the needs of customers, come grow a fulfilling career with us! 
 
Through our paid, industry-leading training, you will learn the ins and outs of the claims process and be ready to assist our policyholders when they need us the most &ndash; during an accident. As a Claims Service Specialist, you will collect facts about the accident, investigate claim details, and collect statements from involved parties. Our policyholders will count on your patience, support, and attention to detail to get them back on the road as quickly as possible. GEICO will also give you the space and grace to explore your abilities and learn new ones. So if you are ready to start growing your career, let&rsquo;s talk! 
Qualifications &amp; Skills:<ul><li>
Experience providing outstanding customer service by showcasing expertise, fostering trust and growing customer satisfaction</li><li>
Solid computer multitasking skills</li><li>
Ability to effectively communicate, verbally and in writing, and willingness to expand on these abilities</li><li>
Ability to work comfortably and grow in a fast-paced, high-volume call center environment</li><li>
Minimum of high school diploma or equivalent, college degree or currently pursuing preferred</li><li>
Eagerness to explore new skills and openness to different career paths</li></ul>
#geico700 

At this time, GEICO will not sponsor a new applicant for employment authorization for this position. 
The GEICO Pledge:
Great Company: At GEICO, we help our customers through life&rsquo;s twists and turns. Our mission is to protect people when they need it most and we&rsquo;re constantly evolving to stay ahead of their needs.
We&rsquo;re an iconic brand that thrives on innovation, exceeding our customers&rsquo; expectations and enabling our collective success. From day one, you&rsquo;ll take on exciting challenges that help you grow and collaborate with dynamic teams who want to make a positive impact on people&rsquo;s lives.
Great Careers: We offer a career where you can learn, grow, and thrive through personalized development programs, created with your career &ndash; and your potential &ndash; in mind. You&rsquo;ll have access to industry leading training, certification assistance, career mentorship and coaching with supportive leaders at all levels.
Great Culture: We foster an inclusive culture of shared success, rooted in integrity, a bias for action and a winning mindset. Grounded by our core values, we have an an established culture of caring, inclusion, and belonging, that values different perspectives. Our teams are led by dynamic, multi-faceted teams led by supportive leaders, driven by performance excellence and unified under a shared purpose.
As part of our culture, we also offer employee engagement and recognition programs that reward the positive impact our work makes on the lives of our customers.
Great Rewards: We offer compensation and benefits built to enhance your physical well-being, mental and emotional health and financial future.<ul><li>
Comprehensive Total Rewards program that offers personalized coverage tailor-made for you and your family&rsquo;s overall well-being.</li><li>
Financial benefits including market-competitive compensation; a 401K savings plan vested from day one that offers a 6% match; performance and recognition-based incentives; and tuition assistance.</li><li>
Access to additional benefits like mental healthcare as well as fertility and adoption assistance.</li><li>
Supports flexibility- We provide workplace flexibility as well as our GEICO Flex program, which offers the ability to work from anywhere in the US for up to four weeks per year.</li></ul>
The equal employment opportunity policy of the GEICO Companies provides for a fair and equal employment opportunity for all associates and job applicants regardless of race, color, religious creed, national origin, ancestry, age, gender, pregnancy, sexual orientation, gender identity, marital status, familial status, disability or genetic information, in compliance with applicable federal, state and local law. GEICO hires and promotes individuals solely on the basis of their qualifications for the job to be filled.
GEICO reasonably accommodates qualified individuals with disabilities to enable them to receive equal employment opportunity and/or perform the essential functions of the job, unless the accommodation would impose an undue hardship to the Company. This applies to all applicants and associates. GEICO also provides a work environment in which each associate is able to be productive and work to the best of their ability. We do not condone or tolerate an atmosphere of intimidation or harassment. We expect and require the cooperation of all associates in maintaining an atmosphere free from discrimination and harassment with mutual respect by and for all associates and applicants.</div>

Optum

<div>This position follows a hybrid schedule with employees will be required to work some days onsite and some days from home. Our office is located at OptumHealth Public Sector, 3131 Camino Del Rio North, Suite 700, San Diego, CA, 92108.
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.
This is a challenging role that takes an ability to thoroughly review, analyze and research complex healthcare claims in order to identify discrepancies, verify pricing, confirm prior authorizations and process them for payment. You'll need to be comfortable navigating across various computer systems to locate critical information. Attention to detail is critical to ensure accuracy which will support timely processing of the member's claim.
This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 5:00pm PST. It may be necessary, given the business need, to work occasional overtime.
We offer 90 days of online and onsite on the job training aligned to your schedule. 
Primary Responsibilities:<ul><li>
Provide expertise or general claims support by reviewing, researching, investigating, negotiating, processing, and adjusting claims</li><li>
Analyze and identify trends and provide reports as necessary</li><li>
Consistently meet established productivity, schedule adherence and quality standards</li><li>
Other duties as assigned</li></ul> 
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:<ul><li>
High School Diploma / GED OR equivalent work experience</li><li>
Must be 18 years of age OR older</li><li>
1+ years of experience in a related environment (i.e., office, administrative, clerical, customer service, etc.), using phones and computers as the primary job tools</li><li>
Experience using computers and Windows based applications, which includes the ability to learn new and complex computer system applications</li><li>
1+ years of experience using Microsoft Office applications</li><li>
1+ years of experience with processing medical, dental, prescription, OR mental health claims</li><li>
Ability to work full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 5:00pm PST. It may be necessary, given the business need, to work occasional overtime.</li></ul> 
Telecommuting Requirements:<ul><li>
Reside within commutable distance to the office at OptumHealth Public Sector, 3131 Camino Del Rio North, Suite 700, San Diego, CA, 92108</li><li>
Ability to keep all company sensitive documents secure (if applicable)</li><li>
Required to have a dedicated work area established that is separated from other living areas and provides information privacy.</li><li>
Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.</li></ul> 
Soft Skills:<ul><li>
Ability to work independently and prioritize tasks</li><li>
Display strong work ethic, independence, and dependability</li><li>
Exhibit excellent time management, organizational, and prioritization skills</li><li>
Demonstrate the ability to multitask</li><li>
Possess effective interpersonal, influence, collaboration, and listening skills</li><li>
Drive for results individually and in a team setting</li></ul> 
<ul><li>All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy</li></ul> 
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). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $17.98 - $32.12 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 
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. 
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law 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, or any other characteristic protected by local, state, or federal laws, rules, or regulations. 
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. 
#RPO</div>

Claims Representative

<div>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. 
Primary Responsibilities:<ul><li>
Authorizes the appropriate payment or refers claims to investigators for further review</li><li>
Conducts data entry and claims processing/issues</li><li>
Handling issues within turnaround standards</li><li>
Ability to handle most claim types / cases / issues that are submitted to the team you are supporting</li><li>
Ability handle escalations as needed</li><li>
Ability to work multiple functions and applications in a day as needed</li><li>
Communicate any changes in trending of inventory, volumes, and quality remediation</li><li>
Complete required individual development courses / training</li><li>
Meet and maintain minimum quality and productivity standards</li></ul> 
*** ENGLISH PROFICIENT ASSESSMENT WILL BE REQUIRED AFTER APPLICATION *** 
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:<ul><li>
1+ years of experience in a production environment</li><li>
Proficient in MS Office with solid computer skills (e.g. multiple systems experience, keyboarding skills, Microsoft word, Power Point)</li><li>
Proficient in verbal and written English skills</li><li>
Willing or able to work 40 hours / week during standard business operating hours Monday - Friday from 7am - 7pm AST (It may be necessary, given the business need, to work occasional overtime on weekends and holidays)</li></ul> 
Preferred Qualifications:<ul><li>
Experience in medical billing or claims</li><li>
Healthcare experience</li></ul> 
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.</div>

Claims Representative - San Juan, PR

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