Recovery Resolutions Representative - San Juan, PR

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 Recovery Resolutions Representative supports the two parts of the Prospective Investigations process by identifying and keying specific detail from the medical records and determine if the claims proceed with a payment. Incumbents are responsible for dealing professionally and ethically safeguarding confidential information, adhering to UHG's Principles of Integrity and Compliance. This position is critical to the success of the Investigative teams and their ability to meet required internal and mandated turn-around times.

Primary Responsibilities:

• Data enter key detail from the medical records and claim platform into an online communication
• Meet required productivity and quality metrics
• Adherence to state and federal compliance policies and contract compliance
• Assist the prospective team with special projects and reporting

ENGLISH PROFICIENCY ASSESSMENT WILL BE REQUIRED AFTER APPLICATION

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 within a Healthcare environment using the computer as the primary instrument to perform job duties
• Production environment experience
• Working experience with Microsoft Tools: Microsoft Teams (join meetings and trainings), Microsoft Power Point (prepare presentations), Microsoft Word (creating memos, writing), Microsoft Outlook (setting calendar appointments, email) and Microsoft Excel (creating spreadsheets, filtering, navigating reports)
• Available to work (40 hours/week) Monday - Friday. Flexible to work any of our 8-hour shift schedules during our normal business hours of (6:00am to 6:00pm EST). It may be necessary, given the business need, to occasionally work mandatory overtime, holidays or weekends
• English proficiency
• Driver's License and access to reliable transportation

Preferred Qualifications:

• Coding experience
• Managed care experience
• Claims processing experience
• Medical records familiarity

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

Client-provided location(s): Gunnison, CO

Job ID: UHG-2354713

Employment Type: OTHER

Posted: 2026-04-11T20:24:17