Claims Representative

Company Description Optum, part of UnitedHealth Group (NYSE: UNH), focuses on evolving health care so individuals can live their healthiest lives. The organization centers care around people’s unique needs, making it easier and more affordable to manage health and well-being. Optum delivers the right care when and how it is needed, offers support to make informed health decisions, and simplifies prescription services while helping reduce costs. Team members contribute to shaping what health care should be, working together to create better health outcomes for communities.
Role Description This is a full-time, on-site Claims Representative role based in Gurgaon. The Claims Representative reviews, evaluates, and processes insurance claims in accordance with company policies, regulatory requirements, and service-level standards. Responsibilities include verifying claim information, assessing coverage, identifying property damage details where applicable, and determining appropriate claim resolutions. The role involves communicating with customers, providers, and internal teams to gather documentation, clarify claim status, and resolve issues promptly. The Claims Representative is expected to maintain accurate records, use claims management systems effectively, and contribute to continuous improvement in claims operations and customer experience.
Qualifications
Strong claims handling and claims management skills, including the ability to review, analyze, and process claims accurately and efficiently.
Knowledge of insurance principles and processes, with familiarity in property damage claims or related insurance products.
Excellent customer service skills, with the ability to handle inquiries, explain claim decisions clearly, and manage sensitive interactions professionally.
Attention to detail and strong analytical abilities for interpreting policy terms, verifying documentation, and identifying discrepancies.
Proficiency with claims processing systems, office productivity tools, and documentation practices.
Effective written and verbal communication skills, and the ability to collaborate with cross-functional teams.
Ability to work in an on-site, fast-paced environment in Gurgaon, managing multiple cases and meeting deadlines.
Relevant experience in claims or insurance operations; a diploma or degree in business, finance, or a related field is preferred.

Work arrangement
No