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Claims Processing Representative
hace 1 semana
The Claims Processing Representative at Optum is responsible for supporting the Prospective Investigations process by identifying and keying specific details from medical records. This role ensures the accuracy and efficiency of claims processing, directly impacting the success of our Investigative teams. As a Claims Processing Representative, you will work closely with our investigative teams to meet internal and mandated turn-around times while maintaining confidentiality and adhering to our Principles of Integrity and Compliance.
This position requires strong organizational skills and attention to detail to manage multiple tasks and deadlines. You will also be responsible for adhering to state and federal compliance policies and contract requirements.
Responsibilities:
- Data entry of key details from medical records and claim platforms into online communication systems
- Meet productivity and quality metrics to ensure timely and accurate processing of claims
- Adhere to state and federal compliance policies and contract requirements
- Assist the prospective team with special projects and reporting as needed
Requirements:
- 1+ years of experience in a healthcare environment using computers for job duties
- Production environment experience
- Working knowledge of Microsoft tools: Teams, PowerPoint, Word, Outlook, and Excel
- Availability to work 40 hours/week, Monday-Friday, with flexibility to work various shift schedules
- English proficiency
Preferred Qualifications:
- Coding experience
- Managed care experience
- Claims processing experience
- Medical record familiarity
We value diversity and inclusion in our workplace and strive to create an environment where everyone can thrive. Join us today and contribute to improving health outcomes
