Job Title: Claims Associate
Requisition Number: 2313825
Job Category: Claims
Primary Location: Hyderabad, Telangana, India
Company Overview
Optum is a global organization focused on delivering care through technology, helping millions of people live healthier lives. The company promotes an inclusive culture with career development opportunities, comprehensive benefits, and a mission-driven approach to health optimization.
Job Purpose
Responsible for reviewing, analyzing, researching, and processing healthcare claims to ensure accurate adjudication, pricing, and payment according to company policies. The role requires strong attention to detail and the ability to navigate multiple computer systems.
Primary Responsibilities
Review, adjudicate, adjust, and rework claims by researching policies, investigating discrepancies, and processing claims accurately.
Verify claim pricing and prior authorizations before processing for payment.
Consistently meet productivity, schedule adherence, and quality standards.
Comply with employment contract terms, company policies, procedures, and directives (including potential reassignments, team changes, or work schedule modifications).
Navigate multiple computer systems to locate critical information for claims processing.
Ensure accuracy and timeliness in all claims processed.
Required Qualifications
Graduate in any discipline (excluding BTech/MCA).
Proficiency in Windows PC applications, including the ability to navigate multiple programs and learn new software systems.
Preferred Qualifications
Freshers or candidates with experience in healthcare claims processing (medical, dental, prescription, or mental health).
Flexibility to work in any shift.
Work from office location.
Working Conditions & Other Requirements
Must follow company policies and adapt to changing business needs.
Attention to detail is critical for timely and accurate claims processing.
Work may require navigating complex computer systems across different applications.
Company Mission & Values
Promote equitable healthcare access and reduce health disparities.
Support diversity, inclusion, and sustainability initiatives.
Deliver quality care and improve health outcomes for all populations.
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