Recovery and Resolutions Representative  

Job Title: Recovery / Resolutions Representatives

Who We Are:

• Optum is a part of the UnitedHealth Group, a Fortune 5company, serving 125 million individual consumers.

• We are a diverse company with over 189,000 employees worldwide and over 14,000 employees in the Philippines

• We are a leader in nearly every aspect of today’s health care landscape

• We leverage on having the largest single proprietary network of physicians, hospitals, health facilities, and caregivers in the United States. At Optum, we believe that what makes you special can inspire your life’s best work.

Welcome to one of the toughest and most fulfilling ways to help people, including you. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life’s best work.SM

Join us today and unlock a world of rewards and benefits for performance, career growth, work-life balance and the opportunity to pursue your passion.

What We Offer:

• Market Competitive Pay Levels

• Retirement Plan

• Medical Plan (HMO) from Day 1 of employment

• Dental, Medical, and Optical Reimbursements

• Life and Disability Insurance

• Paid Time-Off Benefits

• Sick Leave Conversion

• Tuition Fee Reimbursement

• Employee Assistance Program (EAP)

• Annual Performance Based Merit Increases

• Employee Recognition

• Training and Staff Development

• Employee Referral Program

• Employee Volunteerism Opportunity

• All Mandatory Statutory Benefits

Role and Responsibilities:
• Responsible for investigating, recovering, and resolving all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities.
• Answer incoming phone calls in a polite and professional manner. Facilitate the handling of callers' request for information. Route calls to other staff members; take and deliver accurate and complete messages as appropriate. Screen calls and initiate resolution of questions/issues without consultation with others.
• May include initiating telephone calls to members, providers, and other insurance companies to gather coordination of benefits data.
• Investigate and pursue recoveries and payables on subrogation claims and file management. Process recovery on claims.
• Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance.
• May conduct contestable investigations to review medical history. May monitor large claims including transplant cases.

Your role is critical in allowing our members, families, facilities and health professionals to have greater confidence in the exceptional care we provide. And for you, an everyday opportunity to do your life’s best work.SM

Job Qualifications
• Have completed 2 years in college with at least 6 months BPO experience, local account is considered.
• Must be willing to work in Muntinlupa
• Open to shifting schedules, graveyard shift (9 pm – 6 am)