COB Outreach Coordinator - San Juan, PR

Posted 5 Hours Ago
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San Juan, PRI
In-Office
Junior
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
The Role
Resolves escalated provider and member issues related to coordination of benefits. Verifies other insurance coverage, conducts outreach to payers and employer groups, gathers claim information, enters findings into internal systems, determines insurance primacy, and updates records for accurate claims processing. Ensures compliance with applicable policies and collaborates with internal departments to improve assigned work inventories.
Summary Generated by Built In
Requisition Number: 2391821
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.
The COB Outreach Representative is responsible for resolving escalated provider and member issues. The successful COB Representative will perform root cause analysis, determine primacy, and update all systems to ensure that claims are processed correctly.
Primary Responsibilities:
  • Verify other insurance coverage through automated phone lines, databases, outreach to commercial payers, and other available methods
  • Data entry of other insurance coverage findings into internal applications
  • Initiate phone calls to employer groups, and other insurance companies to gather pertinent claim information, confirmation of services received and coordination of benefits information
  • Work directly with other departments to enhance and refine assigned inventory to maximize value
  • Ensure adherence to state and federal compliance policies, reimbursement policies, and contract compliance
  • Use pertinent data and facts to identify and solve a range of problems within area of expertise
  • Serves as a resource to others
  • Other duties as assigned

*** 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 in an inbound/outbound call center environment
  • 1+ years of experience with data entry
  • Proficiency in Microsoft Office including Word, Excel, PowerPoint, and Outlook (Sort, filtering, summing, formulas, formatting)
  • English Proficiency
  • Willing or ability to work 40 hours weekly from Monday to Friday during our regular business hours from 7am to 7pm (Overtime as business needs dictate)

Preferred Qualifications:
  • Coordination of Benefits experience
  • Experience in healthcare industry

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.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Skills Required

  • At least 1 year of experience in an inbound or outbound call center environment
  • At least 1 year of data entry experience
  • Proficiency in Microsoft Office, including Word, Excel, PowerPoint, and Outlook
  • English proficiency
  • Ability to work 40 hours per week, Monday through Friday, during business hours from 7 a.m. to 7 p.m.
  • Coordination of Benefits experience
  • Healthcare industry experience

What the Team is Saying

Optum Compensation & Benefits Highlights

  • Leave & Time Off Breadth — PTO is generally described as decent or good, and many note it as a strong part of the package. Actual ability to take time off can depend on workload and team coverage.
  • Retirement Support — Offerings include a 401(k) with employer match and access to an employee stock purchase plan, which are highlighted as meaningful components of total rewards. These programs are consistently referenced among core benefits.
  • Parental & Family Support — Parental and caregiver leave, along with adoption assistance, are publicly highlighted and viewed as notable elements of the package. Availability can be role-specific, but these supports contribute to overall breadth where offered.

Optum Insights

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The Company
HQ: Eden Prairie, MN
160,000 Employees
Year Founded: 2011

What We Do

Optum, part of the UnitedHealth Group family of businesses, 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. At Optum, we support your well-being with an understanding team, extensive benefits and rewarding opportunities. By joining us, you’ll have the resources to drive system transformation while we help you take care of your future. We recognize the power of connection to drive change, improve efficiency and make a difference in health care. Join a team where your skills and ideas can make an impact and where collaboration is key to creating technology that produces healthier outcomes.

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Optum Offices

Hybrid Workspace

Employees engage in a combination of remote and on-site work.

Optum has three workplace models that balance the needs of the business and the responsibilities of each role. These models, core on‑site (5 days/week), hybrid (4 days/week) and telecommute or fully remote, vary by country, role and location.

Typical time on-site: Not Specified
HQEden Prairie, MN
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