Optum · 2 days ago
Reclamation Team Lead
Nashville, TN
Full-time
Hybrid
Entry, Mid Level
$23.89/hr - $42.69/hr
1+ years expOptum is focused on improving the flow of health data and creating a more connected system. The Reclamation Team Lead will research issues to determine how to reduce medical costs through claim system processes and business rules, while ensuring data integrity and compliance with policies.
EducationHealth CareMedicalPharmaceutical
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
Qualification
Required
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 medical claims Electronic Data Interchange (EDI) workflows including experience in identifying, researching, and resolving EDI claim errors and rejections
Knowledge of claims processing systems and guidelines/processes
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 (8:00 am - 6:00 pm). It may be necessary, given the business need, to work occasional overtime
Preferred
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
Optum
Optum is a healthcare company that provides pharmacy services, health care operations, and population health management. It is a sub-organization of UnitedHealth Group.
10001+ employees
H1B Sponsorship
Optum has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (648)
2024 (559)
2023 (620)
2022 (851)
2021 (593)
2020 (438)
Funding
Current Stage
Late StageLeadership Team
Daniel Castillo
Chief Executive Officer, Optum Care Delivery
J
Jay Green
Chief Financial Officer
Recent News
2025-11-29
2025-11-19
2025-11-07
Company data provided by crunchbase