Job Information
UnitedHealth Group Call Center Representative (Coordination of Benefits) - San Juan, PR in San Juan, Puerto Rico
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. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
The COB Outreach Representative is responsible for resolving escalated provider and member issues. The successful COB Representative will perform root cause analysis, determine primacy, and update all systems to ensure that claims are processed correctly.
Primary Responsibilities:
Verify other insurance coverage through automated phone lines, databases, outreach to commercial payers, and other available methods
Data entry of other insurance coverage findings into internal applications
Initiate phone calls to employer groups, and other insurance companies to gather pertinent claim information, confirmation of services received and coordination of benefits information
Work directly with other departments to enhance and refine assigned inventory to maximize value
Ensure adherence to state and federal compliance policies, reimbursement policies, and contract compliance
Use pertinent data and facts to identify and solve a range of problems within area of expertise
Serves as a resource to others
Other duties as assigned
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
1+ years of experience in an inbound/outbound call center environment
1+ years of experience with data entry
Proficiency in Microsoft Office including Word, Excel, PowerPoint, and Outlook (Sort, filtering, summing, formulas, formatting)
English Proficiency
Willing or ability to work 40 hours weekly from Monday to Friday during our regular business hours from 7am to 7pm (Overtime as business needs dictate)
Preferred Qualifications:
Coordination of Benefits experience
Experience in healthcare industry
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
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