Medical Claims Specialist

hace 3 días


San Juan, San Juan, Puerto Rico Optum A tiempo completo
Job Overview

Optum is a leading healthcare organization that delivers innovative solutions to improve health outcomes. We are seeking a highly skilled Claims Representative to join our team.

Key Responsibilities
  • Authorize payments or refer claims for further review, ensuring accuracy and efficiency.
  • Conduct data entry and claims processing, meeting turnaround standards and quality expectations.
  • Handle issues and escalations, providing exceptional customer service and support.
  • Communicate trends and changes in inventory, volumes, and quality remediation, driving continuous improvement.
Required Skills and Qualifications
  • 1+ years of experience in a production environment.
  • Proficient in MS Office with solid computer skills, including multiple systems experience and keyboarding skills.
  • Excellent verbal and written English skills.
  • Ability to work 40 hours/week during standard business operating hours, with occasional overtime as needed.


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