Senior Claims Representative - Irvine, CA(Job Number:695695)
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Solid leadership skills with good judgment and objectively. Flexibility in completing assignments in order to meet deliverables. Ability to research and analyze issues with confidence in identifying a resolution and initiative to take action. Ability to handle sensitive material confidentially. Be able to engage with professional interaction in a collaborative manner with both internal and external customers.
Positions in this function are responsible for providing expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting claims. Authorizes the appropriate payment or refers claims to investigators for further review. Conducts data entry and re-work; analyzes and identifies trends and provides reports as necessary.
- Provide expertise or general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims
- Authorize appropriate payment or refer claims to investigators for further review
- Analyze and identify trends and provides reports as necessary
- Consistently meet established productivity, schedule adherence, and quality standards
- Provide excellent customer service
- Extensive work experience, possibly in multiple functions.
- Work does not usually require established procedures.
- Works independently.
- Mentors others.
- Acts as a resource for others.
- Coordinates others' activities.
Keywords: medical claims, healthcare claims, claims processing, claims processor; UnitedHealth Group, UnitedHealth care
Job Claim Operations
Primary Location US-CA-Irvine
Organization OptumRx Claims Operations
Number of Openings 2