Position Description:
United Healthcare International Global Solutions is an innovative program is designed to help U.S.-based employers achieve the highest level of expatriate success by ensuring a seamless, successful experience for employees and their families as they relocate overseas. Our team of multi-lingual professionals, located in Tampa, FL, is caring, innovative and provides decisive personalized service to members, providers, plan sponsors, brokers and vendors 24 hours a day, seven days a week, 365 days a year. Now is the time to apply for this exciting position within United Healthcare International Global Solutions.
The Medical Claims Representative is responsible for the accurate processing and completion of US and International medical claims.
Primary Responsibilities:
- Process claims that route out of automatic adjudication, within current turnaround standards
- Ability to understand and apply plan concepts to include:
- Deductible
- Coinsurance
- Copay
- Out-of-pocket
- State variations
- Provide expertise or general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims
- Recognize issues related to variable deductible, coordination of benefits; carve-out alternate benefits.
- Authorize appropriate payment or refer claims to investigators for further review
- Analyze and identify trends and provides reports as necessary
- Consistently meet established productivity, schedule adherence, and quality standards
- Provide excellent customer service
- Benefit Plan Set-up Testing
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