Claims Representative Associate

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

Location: Gurgaon

Primary Responsibilities:

• Interpret and/or verify contract language, information, and intent to load pricing information into systems properly
• Load/Audit provider contract or implement updates and amendments
• Interpret existing contracts to identify potential problems or issues needing correction
• Provide input/suggestions on projects related to business rules and procedures
• Identify and/or implement potential long-term, permanent solutions to resolve recurring issues and problems (e.g., training, process changes)
• 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 regard 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

• Fresher
• Graduation
• BTECH/BE/MCA/MBA/ B pharm/ M pharm are not eligible to apply
• Proven good communication skills written and verbal
• Proven ability to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each product
• Proven ability to remain focused and productive each day though tasks may be repetitive
• Proven good typing speed (English) and accuracy
• Comfortable working in night shifts (5:45 PM to 3:15 AM & 8:30 PM to 6:00 AM)
• Critical Skills:
  • Proven result-oriented and goal-driven
  • Analytical ability: Research skills combined with effective decision-making and superior interpersonal skills
  • Solid verbal and written communication skills
  • Ability to accept constructive criticism with being coached and growing as a professional
  • Proven citical thinking abilities