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- My Dashboard
- My Profile
- Join Our Talent Community
- English
- Portuguese (Brazil)
- Jobs
- About Us
- Culture
- Disability Inclusion
- Diversity, Equity and Inclusion
- Life at UHG
- Social Responsibility
- What We Offer
- Join Us
- Advice
- Events
- Military and Veterans
- Our Hiring Process
- Career Areas
- Clinical
- Consulting
- Corporate Services
- Customer Service and Claims
- Health Care Operations
- Project Management
- Sales & Marketing
- Technology
- Early Careers
- Blog
- Events
- Internship Programs
- What It’s Like To Work Here
- My Dashboard
- My Profile
- Join Our Talent Community
- English
- Portuguese (Brazil)
Customer Service and Claimsswortel2022-09-16T11:10:00+00:00
Improve the lives of others while doing your life’s best workSM
Customer Service and Claims
What really brings a smile to your face? Is it being able to make connections and build relationships with people from across the globe? How about making someone’s day with an answer to their question or making their life easier by having a solution to their problem? If you’re looking for a more inspired career with greater impact and meaning, join us and discover your life’s best work.SM
Billing
How do you like your challenges? If you like complex and enormous, we might have a position with your name on it. Here you’ll be surrounded by a team working hard to gather information and generate accurate billing statements, getting to the bottom of things for those we serve. You’ll also provide valuable input to our evolving policies, leading to a win-win situations for our members, our partners and for the people on our high performing teams.
What We Are Looking For
- Attention to detail, able to find missing or inconsistent information
- Ability to engage patiently with members and colleagues to gather critical information
- Desire to implement process improvements to create efficiencies and better outcomes
- Interacts with customers to gather support data and works to resolve discrepancies.
- Help educate our customers on the processing of payments through online application.
- Responsible for medical and ancillary product premium billing
- Responsible for management and administration of multiple functions within the Billing Department.
Claims
What’s your next move? How about right to the leading edge of health care. Working on Claims is not a job for everyone. We’re constantly gathering and analyzing information. If you believe that smart and decisive actions start with you, we can provide the challenge you need and the career opportunities you want.
Our Hiring Process
What We Are Looking For
- Ability to carefully examine documentation and explore for further details when needed
- Analytical and curious, intent on asking questions and finding answers
- Comfortable presenting findings to appropriate parties even when delivering difficult decisions
- Provides support by reviewing, researching, investigating, and processing claims.
- Authorize payment and enter into our company database.
- Research & review processed claims for necessary adjustments or corrections.
Recovery Resolution Representative
- Conducts research to identify errors in claims processing
- May work with other organizations to arrange for reimbursements.
Senior Appeals Representative
- Communicates with appropriate parties regarding appeals and grievance issues, implications and decisions.
- Analyzes and identifies trends for all appeals and grievances.
- Provides expertise and general claims support to team in reviewing, researching and negotiating and processing of claims.
Customer Service
As part of our Customer Service team, you will be taking calls from members and/or providers and using programs and tools to research their specific benefits plans. And if you are bilingual, your impact can be even greater as you use your language skills to connect with members in other languages. Bringing empathy and attentiveness helps our customer service teams to understand where people are coming from as they compassionately provide support.
Learn More About the Role
Mary. J describes how a role in Customer Service went from being a job to a career.
Customer Service Career Path
Learn More About the Role
Employees describe what it’s like to work here in Customer Service at our company.
Customer Service Representative
- Assist members and providers with questions and concerns.
- Depending on the business you work in, your responsibilities may vary.
Customer Service Advocate
- Help members make informed decisions about their care services by answering questions and resolving their issues.
Senior Customer Service Representative
- Responsible for handling more complex issues related to our members and providers.
- Help ensure a high level of support with quick resolution.
Customer Service Supervisor
- Make sure the goal of connecting with members and providers is met, while enhancing the customer experience.
- Mentor, challenge and communicate effectively with different types of people.
Enrollment and Eligibility
As part of our Enrollment and Eligibility team, you’ll work with experienced colleagues to facilitate the enrollment of new members. Data entry and updates, responding to member eligibility or group questions are just a few ways your problem-solving skills will be vitally important. This is a chance to take your career to new levels of influence and impact.
What We Are Looking For
- One or more years of experience in an administrative role in an office environment as well as a high school diploma/GED or equivalent work experience
- Proficient computer skills including data entry and navigating Microsoft Office programs
- Compassionate individuals with strong relationship building skills
Enrollment and Eligibility Representative
- Receiving, reviewing, processing, and maintaining new member group enrollment information.
Enrollment and Eligibility Supervisor
- Overseeing day to day activities related to enrollment and eligibility operations.
Enrollment and Eligibility Manager
- Management and administration of multiple functions within the department
Pharmacy Services
As part of our Pharmacy Services team, you will be taking calls from members and/or providers and using programs and tools to research their specific benefits plans. Here, the work that you will do every day ensures our members receive medications that are critical to their health and well-being.
Learn More About the Role
Employees describe what it’s like to work as a Pharmacy Technician with OptumRx.
- Perform technical and clerical tasks.
- Perform tasks regarding pharmacy quality control, inventory control and preparation of orders of drugs.
- Provide support to the pharmacy staff in a variety of capacities.
- Monitor drug inventory
- Process drug purchases, verify shipments against invoices and maintain proper storage of drug inventory.
Senior and Lead Pharmacy Technician
- Interpret physician’s prescriptions and creates order.
- Access, input, and retrieve prescription information from computer systems, and verify whether order is reimbursable.
- Dispense: united doses, specialty pharmaceuticals and injectables.
- Review and approve pending requests prior authorizations.
Billing
How do you like your challenges? If you like complex and enormous, we might have a position with your name on it. Here you’ll be surrounded by a team working hard to gather information and generate accurate billing statements, getting to the bottom of things for those we serve. You’ll also provide valuable input to our evolving policies, leading to a win-win situations for our members, our partners and for the people on our high performing teams.
What We Are Looking For
- Attention to detail, able to find missing or inconsistent information
- Ability to engage patiently with members and colleagues to gather critical information
- Desire to implement process improvements to create efficiencies and better outcomes
Billing Representative
- Interacts with customers to gather support data and works to resolve discrepancies.
- Help educate our customers on the processing of payments through online application.
Billing Supervisor
- Responsible for medical and ancillary product premium billing
Billing Manager
- Responsible for management and administration of multiple functions within the Billing Department.
Claims
What’s your next move? How about right to the leading edge of health care. Working on Claims is not a job for everyone. We’re constantly gathering and analyzing information. If you believe that smart and decisive actions start with you, we can provide the challenge you need and the career opportunities you want.
Our Hiring Process
What We Are Looking For
- Ability to carefully examine documentation and explore for further details when needed
- Analytical and curious, intent on asking questions and finding answers
- Comfortable presenting findings to appropriate parties even when delivering difficult decisions
Claims Representative
- Provides support by reviewing, researching, investigating, and processing claims.
- Authorize payment and enter into our company database.
- Research & review processed claims for necessary adjustments or corrections.
Recovery Resolution Representative
- Conducts research to identify errors in claims processing
- May work with other organizations to arrange for reimbursements.
Senior Appeals Representative
- Communicates with appropriate parties regarding appeals and grievance issues, implications and decisions.
- Analyzes and identifies trends for all appeals and grievances.
Claims Supervisor
- Provides expertise and general claims support to team in reviewing, researching and negotiating and processing of claims.
Customer Service
As part of our Customer Service team, you will be taking calls from members and/or providers and using programs and tools to research their specific benefits plans. And if you are bilingual, your impact can be even greater as you use your language skills to connect with members in other languages. Bringing empathy and attentiveness helps our customer service teams to understand where people are coming from as they compassionately provide support.
Learn More About the Role
Mary. J describes how a role in Customer Service went from being a job to a career.
Customer Service Career Path
Learn More About the Role
Employees describe what it’s like to work here in Customer Service at our company.
Customer Service Representative
- Assist members and providers with questions and concerns.
- Depending on the business you work in, your responsibilities may vary.
Customer Service Advocate
- Help members make informed decisions about their care services by answering questions and resolving their issues.
Senior Customer Service Representative
- Responsible for handling more complex issues related to our members and providers.
- Help ensure a high level of support with quick resolution.
Customer Service Supervisor
- Make sure the goal of connecting with members and providers is met, while enhancing the customer experience.
- Mentor, challenge and communicate effectively with different types of people.
Enrollment and Eligibility
As part of our Enrollment and Eligibility team, you’ll work with experienced colleagues to facilitate the enrollment of new members. Data entry and updates, responding to member eligibility or group questions are just a few ways your problem-solving skills will be vitally important. This is a chance to take your career to new levels of influence and impact.
What We Are Looking For
- One or more years of experience in an administrative role in an office environment as well as a high school diploma/GED or equivalent work experience
- Proficient computer skills including data entry and navigating Microsoft Office programs
- Compassionate individuals with strong relationship building skills
Enrollment and Eligibility Representative
- Receiving, reviewing, processing, and maintaining new member group enrollment information.
Enrollment and Eligibility Supervisor
- Overseeing day to day activities related to enrollment and eligibility operations.
Enrollment and Eligibility Manager
- Management and administration of multiple functions within the department
Pharmacy Services
As part of our Pharmacy Services team, you will be taking calls from members and/or providers and using programs and tools to research their specific benefits plans. Here, the work that you will do every day ensures our members receive medications that are critical to their health and well-being.
Learn More About the Role
Employees describe what it’s like to work as a Pharmacy Technician with OptumRx.
Pharmacy Technician
- Perform technical and clerical tasks.
- Perform tasks regarding pharmacy quality control, inventory control and preparation of orders of drugs.
Pharmacy Clerk
- Provide support to the pharmacy staff in a variety of capacities.
- Monitor drug inventory
- Process drug purchases, verify shipments against invoices and maintain proper storage of drug inventory.
Senior and Lead Pharmacy Technician
- Interpret physician’s prescriptions and creates order.
- Access, input, and retrieve prescription information from computer systems, and verify whether order is reimbursable.
- Dispense: united doses, specialty pharmaceuticals and injectables.
- Review and approve pending requests prior authorizations.