Claims Representative - San Juan, PR Job at Optum in San Juan

Join to apply for the Claims Representative - San Juan, PR role at Optum

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. We foster a culture guided by diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Join us to make an impact on the communities we serve as we advance health equity globally. Caring. Connecting. Growing together.

Primary Responsibilities

• Authorize appropriate payments or refer claims for further review
• Conduct data entry and claims processing/issues resolution
• Handle issues within turnaround standards
• Manage most claim types/cases/issues submitted to your team
• Handle escalations as needed
• Work across multiple functions and applications as required
• Communicate changes in inventory, volumes, and quality remediation trends
• Complete required individual development courses/training
• Maintain minimum quality and productivity standards
• English proficiency assessment required after application

You will be rewarded and recognized for your performance in a challenging environment that provides clear success pathways and development opportunities.

Required Qualifications

• At least 1 year of experience in a production environment
• Proficient in MS Office and computer skills (e.g., multiple systems, keyboarding, Word, PowerPoint)
• Proficient in verbal and written English
• Willing or able to work 40 hours/week during standard business hours (7am - 7pm AST, Monday - Friday), with possible overtime on weekends and holidays

Preferred Qualifications

• Experience in medical billing or claims
• Healthcare experience

At UnitedHealth Group, our mission is to help people live healthier lives and improve the health system for everyone. We are committed to equity and addressing health disparities affecting marginalized groups.

Additional Information

• Seniority level: Entry level
• Employment type: Full-time
• Job function: Finance and Sales
• Industries: Hospitals and Healthcare

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Location: San Juan, Puerto Rico

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