senior recovery resolutions representative - Taguig city, ncrUnitedHealth Group
Workplace: MetroManila, Manila, Taguig
Salary: Agreement
Work form: Full time
Posting Date: 08/11/2025
Deadline: 14/11/2020
Position Description
The health care system is still evolving at a rapid pace. Technology is driving new advances in how patient care is delivered and how it's reimbursed. Now Optum, part of the UnitedHealth Group family of businesses, invites you to help us build a more accurate and precise approach to claims adjudication. As part of our Recovery and Resolutions team, you'll help understand and overcome errors in claims processing. You'll have all the tools and backing you need to help manage subrogation files, negotiate settlements and ensure adherence to compliance policies. All the while, you'll be building your career with a leader and reaching for the highest levels of performance as you do your life's best work.(sm)
Positions in this function are responsible for investigating, recovering and resolving all types of claims as well as recovery and resolution for health plans, commercial customers and government entities. May include initiating telephone calls to members, providers and other insurance companies to gather coordination of benefits data. Investigate and pursue recoveries and payables on subrogation claims and file management. Process recovery on claims. Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance. May conduct contestable investigations to review medical history. May monitor large claims including transplant cases. Work does not usually require established procedures.
Primary Responsibilities:
Provide claims expertise support by reviewing, researching, investigating, negotiating and resolving all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities
Analyze, identify trends and provide reports as necessary
Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance
Manage subrogation files
Work independently
Mentor others
Act as a resource for others
Coordinate others' activities
Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so
This is a challenging role with serious impact. You'll need to sort through complex situations to understand and clarify where errors happened or where they may continue to happen. It's a fast-paced environment that takes focus, intensity and resilience.
Required Qualifications:
1+ years of claims or collections experience
1+ years of experience analyzing and solving customer problems
Preferred Qualifications:
Experience working with subrogation
Experience with negotiations
Experience working in the health care industry
Optum is a team of more than 260,000 people who are building career success through commitment, compassion and a desire to make a difference. Join us. Learn more about how you can start doing your life's best work.(sm)
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)
Diversity creates a healthier atmosphere: Optum is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
Optum is a drug-free workplace. © 2020 Optum Global Solutions (Philippines) Inc. All rights reserved.
Job Keywords: Senior Recovery Resolutions Representative, Claims, Collections, Taguig City, NCR, National Capital Region
UnitedHealth Group
The health care system is still evolving at a rapid pace. Technology is driving new advances in how patient care is delivered and how it's reimbursed. Now Optum, part of the UnitedHealth Group family of businesses, invites you to help us build a more accurate and precise approach to claims adjudication. As part of our Recovery and Resolutions team, you'll help understand and overcome errors in claims processing. You'll have all the tools and backing you need to help manage subrogation files, negotiate settlements and ensure adherence to compliance policies. All the while, you'll be building your career with a leader and reaching for the highest levels of performance as you do your life's best work.(sm)
Positions in this function are responsible for investigating, recovering and resolving all types of claims as well as recovery and resolution for health plans, commercial customers and government entities. May include initiating telephone calls to members, providers and other insurance companies to gather coordination of benefits data. Investigate and pursue recoveries and payables on subrogation claims and file management. Process recovery on claims. Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance. May conduct contestable investigations to review medical history. May monitor large claims including transplant cases. Work does not usually require established procedures.
Primary Responsibilities:
Provide claims expertise support by reviewing, researching, investigating, negotiating and resolving all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities
Analyze, identify trends and provide reports as necessary
Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance
Manage subrogation files
Work independently
Mentor others
Act as a resource for others
Coordinate others' activities
Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so
This is a challenging role with serious impact. You'll need to sort through complex situations to understand and clarify where errors happened or where they may continue to happen. It's a fast-paced environment that takes focus, intensity and resilience.
Required Qualifications:
1+ years of claims or collections experience
1+ years of experience analyzing and solving customer problems
Preferred Qualifications:
Experience working with subrogation
Experience with negotiations
Experience working in the health care industry
Optum is a team of more than 260,000 people who are building career success through commitment, compassion and a desire to make a difference. Join us. Learn more about how you can start doing your life's best work.(sm)
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)
Diversity creates a healthier atmosphere: Optum is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
Optum is a drug-free workplace. © 2020 Optum Global Solutions (Philippines) Inc. All rights reserved.
Job Keywords: Senior Recovery Resolutions Representative, Claims, Collections, Taguig City, NCR, National Capital Region
UnitedHealth Group
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Taguig City, Metro Manila
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