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Job Details


UnitedHealth Group

Healthcare Investigation Representative - Cebu City, Cebu

Healthcare

Healthcare Network Director

No

Cebu, Cagayan Valley, Philippines

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

The health care system is still evolving at a rapid pace. Technology is driving new advances in how patient care is delivered and how it's reimbursed. Now, UnitedHealth Group invites you to help us build a more accurate and precise approach to claims adjudication. As part of our Recovery and Resolutions team, you'll help understand and overcome errors in claims processing. You'll have all the tools and backing you need to help manage subrogation files, negotiate settlements and ensure adherence to compliance policies. All the while, you'll be building your career with a leader and reaching for the highest levels of performance as you do your life's best work.(sm)

Primary Responsibilities:

  • Provide claims expertise support by reviewing, researching, investigating, negotiating and resolving all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities
  • Analyze, identify trends and provide reports as necessary
  • Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance
  • Manage subrogation files
  • Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so

This is a challenging role with serious impact. You'll need to sort through complex situations to understand and clarify where errors happened or where they may continue to happen. It's a fast paced environment that takes focus, intensity and resilience.

Required Qualifications:

  • At least 2nd year College Undergraduate and or Professionals
  • Minimum of 6 months or 1+ years of claims or collections experience
  • 1+ years of experience analyzing and solving customer problems
  • Ability to work independently

Preferred Qualifications:

  • Experience working with subrogation
  • Experience with negotiations
  • Experience working in the health care industry


UnitedHealth Group is a team of more than 260,000 people who are building career success through commitment, compassion and a desire to make a difference. Join us. Learn more about how you can start doing your life's best work.(sm)

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

Diversity creates a healthier atmosphere: Optum 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.

Optum is a drug-free workplace. © 2022 Optum Global Solutions (Philippines) Inc. All rights reserved.

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