Enrollment Eligibility Representative - National Remote

$3000 Sign On Bonus For External Candidates

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

All of us have a short list of the things that make a job great. If your list includes being able to make a difference, count us in as your next place to work. UnitedHealth Group is a Fortune 5 company leader in health care at a time when health care is evolving for everyone. Our billing teams are part of an important chain of events that impact the lives of our members in positive ways. Join this group and we’ll have an impact on you. Apply now and discover the exceptional training, support and opportunities to grow that you’d expect from a Fortune 5 company.

What makes this a special challenge? For one, we want to create a quality experience for every person we serve. So, the bar is high for accuracy, communications style and effectiveness. Also, you’ll need to be researching and resolving problems before, during and after calls within a high volume, demanding environment.

This position is full - time (40 hours / week). Employees are required to work any shift between the hours of 8:30 AM - 6:30 PM EST (Eastern Standard Time).

We offer on the job training. Training will be conducted virtually from your home.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary Responsibilities:

• Acts as a technical resource to others in own function
• Receive and / or clarify enrollment / eligibility update requests from internal and / or external customers
• Identify performance gaps and / or implement improvements to enrollment / eligibility processes
• Communicate with stakeholders to obtain new information and / or clarify concerns based on initial enrollment / eligibility submissions
• Compare submitted enrollment / eligibility information to relevant internal or external systems to identify incorrect data
• Enter enrollment / eligibility information into relevant databases and systems
• Comply with policies, procedures, and production standards when processing enrollment data or resolving eligibility errors and issues
• Review existing enrollment / eligibility files or forms and data to research and investigate eligibility / membership issues and / or customer discrepancies
• Attend daily, weekly, and monthly Team meetings
• Make and / or submit to relevant internal teams / partners (e.g., data processing teams) any requested changes / additions to enrollment / eligibility applications
• Collaborate / work with internal and / or external stakeholders (e.g., customers; vendors; brokers; internal teams) to correct errors, issues, or concerns identified and request and / or create reports / research
• Work with relevant internal and / or external partners to resolve escalated issues as needed
• Utilize appropriate desktop system tools to manage and report enrollment / eligibility information (e.g., Microsoft Access, Excel)
• Inform internal and / or external customers regarding enrollment - related policies, procedures, and regulations (e.g., HIPAA; PHI; health - care reform)
• Enter manually and / or utilize macros to update member eligibility information into relevant systems (e.g., eligibility host systems)
• Participate in meetings with customers and / or account management to identify and / or review on - going eligibility issues, new business opportunities, or open enrollment
• Create and / or send correspondence to external customers (e.g., members; groups)
• Ensure internal and external confidentiality standards are complied with when loading and working with protected health information (PHI)
• Sort paper enrollment / eligibility applications by group/customer to route work to the appropriate resource
• Review/discuss on - going eligibility issues with internal and / or external stakeholders to facilitate accurate maintenance of membership data
• Communicate with stakeholders (e.g., brokers; customers; vendors) to obtain new information and / or clarify concerns based on initial enrollment / eligibility submissions (e.g., applications)
• Review eligibility guidelines and enrollment criteria with customers / groups to ensure compliance and understanding
• Work with cross - functional business partners/departments to ensure readiness for open / annual enrollments
• Submit enrollment / eligibility information update requests to appropriate internal partners
• Create and / or submit standard or ad hoc reports / information (e.g., census counts; eligibility headcounts) to respond to internal and / or external customers' requests
• Compare submitted enrollment / eligibility information to relevant internal or external systems to identify incorrect data
• Comply with policies, procedures, and production standards when completing data entry or resolving eligibility errors and issues
• Process paper / electronic enrollment / eligibility applications for new and/or existing customers
• Prioritize applications by date received and performance guarantees
• Utilize knowledge of plan document or contract rules
• Develop and / or apply non - standard solutions to handle unique / challenging enrollment / eligibility issues (e.g., system limitations)
• Track and/or monitor turnaround times, volumes, and back - logs to ensure goals are met and that workloads are balanced

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• 1+ years of Microsoft Office experience in working with Microsoft Excel
• 1+ years of experience with working in a productive environment, including the proven ability to meet goals
• Ability to work any shift between the hours of 8:30 AM - 6:30 PM EST (Eastern Standard Time)
• High School Diploma / GED (or higher)

Preferred Qualifications:

• 1+ years of enrollment experience
• 1+ years of experience with COSMOS, UNET / CDB, AR: M, PeopleSoft Financials, and BRMS helpful
• 1+ years of Marco experience
• 1+ years of billing experience

Telecommuting Requirements:

• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
• Ability to keep all company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy

Soft Skills:

• Written and oral communication skills
• Problem - solving skills
• Organizational skills
• Attention to detail

Taking care of business at UnitedHealth Group translates to more meaning and impact as you help improve the lives of millions. Join us. Learn more about how you can start doing your life’s best work. SM

Careers with OptumInsight . Information and technology have amazing power to transform the Healthcare industry and improve people's lives. This is where it's happening. This is where you'll help solve the problems that have never been solved. We're freeing information so it can be used safely and securely wherever it's needed. We're creating the very best ideas that can most easily be put into action to help our clients improve the quality of care and lower costs for millions. This is where the best and the brightest work together to make positive change a reality. This is the place to do your life’s best work. SM

California, Colorado, Connecticut, Nevada, New Jersey, New York, Washington, or Rhode Island Residents Only: The salary range for California / Colorado / Connecticut / Nevada / New Jersey / New York / Washington / Rhode Island residents is $16.00 - $31.44. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

**PLEASE NOTE** The sign on bonus is only available to external candidates. Candidates who are currently working for a UnitedHealth Group, UnitedHealthcare or related entity in a full time, part time, or per diem basis ("Internal Candidates") are not eligible to receive a sign on bonus.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action 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.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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