UnitedHealth Group Hiring for Claims Representative – San Diego, CA at San Diego, CA Full Time

If you are located within a commutable distance of San Diego, CA, you will have the flexibility to work from home and the office in this hybrid role* 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, 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.

It’s that time, isn’t it? You’re ready for the next step forward and an opportunity to build on your skills. And it just so happens that there’s never been a better time to get on the team at UnitedHealth Group . We’ve built one of the world’s most effective and respected claims processing teams. And that’s where you come in. We’ll look to you to maintain our reputation for service, accuracy and providing a positive claims experience. We’ll back you with the great training, support and opportunities you’d expect from a Fortune 5 company leader.

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). Employees are required to work any shift between the hours of 8:00 AM – 5:00 PM including the flexibility to work occasional overtime based on business need. We offer 90 days of online and onsite training.

Our office is located at OPTUMHEALTH PUBLIC SECTOR, 3131 CAMINO DEL RIO NORTH, SUITE 700, SAN DIEGO, CA, 92108. Employees will be required to work some days onsite and some days from home.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary Responsibilities:

• Provide expertise or general claims support by reviewing, researching, investigating, negotiating, processing, and adjusting claims
• Analyze and identify trends and provide reports as necessary
• Consistently meet established productivity, schedule adherence and quality standards

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 higher) OR equivalent years of work experience
• 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
• Proficiency with using computer and Windows personal computer applications, which includes the ability to learn new and complex computer system applications
• Ability to work any shift between the hours of 8:00 AM – 5:00 PM including the flexibility to work occasional overtime based on business need

Preferred Qualifications:

• 1+ years of experience with processing medical, dental, prescription, OR mental health claims

Telecommuting Requirements:

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

Making claims a positive experience for our members can drive your sense of impact and purpose. Join us as we improve the lives of millions. Learn more about how you can start doing your life’s best work. SM

Careers with Optum . Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged, and high-performing teams to help solve important challenges.

California Residents Only: The salary range for California residents is $16.00 – $31.44. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

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.

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