Optum is a part of UnitedHealth Group, dedicated to improving health data flow and creating a connected healthcare system. The Reclamation Team Lead will oversee a team focused on investigating and resolving claims to reduce medical costs, ensuring compliance and optimizing processes.
Responsibilities
- Examine, assess, and document business operations and procedures to ensure data integrity, data security and process optimization
- Investigate, recover, and resolve all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities
- Investigate and pursue recoveries and payables on subrogation claims and file management
- Initiate phone calls to other insurance companies to gather coordination of benefits information
- Process recovery on claims
- 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
Skills
- High School Diploma / GED or equivalent work experience
- Must be 18 years or older
- 1+ years of experience analyzing data and identifying cost saving opportunities OR relevant college courses including economics, statistics, data science, or finance
- Experience in healthcare industry
- Knowledge of claims processing systems and guidelines/processes
- Knowledge of X12 EDI transactions
- Intermediate skills with Microsoft Excel (create, edit, sort, filter, pivot tables)
- Ability to work in the office 3-4 times a week
- Ability to work any of our 8-hour shift schedules during our normal business hours 8:00am - 6:00pm. It may be necessary, given the business need, to work occasional overtime
- 2+ years of experience with claims auditing and researching claims information
- Knowledge of Medicaid/Medicare/Commercial Reimbursement methodologies
Benefits
- Comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase
- 401k contribution
Company Overview
Optum is a healthcare company that provides pharmacy services, health care operations, and population health management. It is a sub-organization of UnitedHealth Group. It was founded in 2011, and is headquartered in Eden Prairie, Minnesota, USA, with a workforce of 10001+ employees. Its website is https://www.optum.com/.Company H1B Sponsorship
Optum has a track record of offering H1B sponsorships, with 648 in 2025, 559 in 2024, 620 in 2023, 851 in 2022, 593 in 2021, 438 in 2020. Please note that this does not guarantee sponsorship for this specific role.
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