Handle inbound calls from healthcare providers regarding medical claim review inquiries, denial reasons, and claim status updates.
Review claim denial explanations and communicate next steps clearly and professionally to providers.
Ensure compliance with internal claims review policies, organizational guidelines, and regulatory requirements.
Demonstrate strong service quality and maintain accuracy in all claim-related communication.
Collaborate with global counterparts to ensure consistent process execution and issue resolution.
Follow all company policies, employment contract terms, and operational directives related to shift changes, reassignment, workflow modifications, and organizational updates.

Job Requirements

Bachelor's degree in any discipline.
Minimum 6 months of experience in an international voice process, preferably in BPO/Healthcare/Claims.
Strong communication skills and the ability to explain claim outcomes clearly.
Ability to maintain professionalism while managing high-volume inbound calls.
Willingness to work in night shifts in a fast-paced, compliance-driven environment.
Prior experience in healthcare claims, provider support, or clinical operations is preferred.
Knowledge of US healthcare processes is advantageous.
Strong problem-solving skills and the ability to handle complex queries.

About Company

Optum, part of UnitedHealth Group, is a global healthcare organization committed to delivering high-quality care supported by advanced technology. Our mission is to help people live healthier lives and to make the healthcare system work better for everyone. Through data-driven solutions, pharmacy benefits, care coordination, and clinical support, we empower millions worldwide. Join a workplace built on inclusion, professional growth, and a strong commitment to improving health outcomes across diverse populations.

Additional Info

The selected candidate will be required to adapt to evolving business needs, workplace structures, and process improvements as required.

Disclaimer: This job description has been sourced from a public domain and may have been modified by Naukri.com to improve clarity for our users. We encourage job seekers to verify all details directly with the employer via their official channels before applying.

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