Patient Care Advocate

hace 16 horas

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

About the Opportunity:

This is an exciting opportunity to join our team as a Clinical Reviewer and contribute to the accuracy and integrity of medical claims. As a key member of our team, you will be responsible for reviewing and investigating claims, identifying potential issues, and working with providers to resolve any discrepancies.

Your Key Responsibilities:

  • Clinical Review: You will review medical claims to determine their validity and accuracy, using your knowledge of clinical guidelines to make informed decisions.
  • Claims Investigations: You will investigate any issues with claims, working closely with providers and other stakeholders to ensure that claims are processed correctly.
  • Compliance: You will ensure that all claims are compliant with relevant regulations and guidelines, including state and federal laws.

Why Join Us?

We offer a range of benefits and perks, including a competitive salary, comprehensive health insurance, and opportunities for career growth and professional development. You will be joining a dynamic and collaborative team that values innovation, excellence, and teamwork.

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