Job Details
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. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life’s best work.SM
Employees in this role are responsible for preparing, processing, and maintaining new member or group enrollments electronically. Team members in this position work with various types of member correspondence and are responsible for reconciling eligibility discrepancies, analyzing transactional data, and submitting retroactive eligibility changes.
This position is full - time (40 hours / week). Employees are required to work between the hours of 8:00AM - 5:00PM CST. It may be necessary, given the business need, to work occasional overtime.
We offer 4 weeks of paid training. The hours during training will be 8:00am to 5:00pm CST.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Primary Responsibilities:
- Receive and process electronic eligibility files for new and/or existing customers
- Review enrollment/eligibility files to identify unclear, missing, or invalid data
- Compare submitted enrollment/eligibility information to relevant internal systems
- Communicate with stakeholders to obtain new information and/or clarify concerns
- Submit and/or review new electronic eligibility files to ensure loaded information is consistent and accurate
- Comply with policies, procedures, and production standards
- Ensure internal and external confidentiality standards are complied with when loading and working with protected health information (PHI)
- Facilitate/lead/participate in meetings with customers and/or internal account management to identify and/or review on-going eligibility issues, new business opportunities, or open enrollment
- Handle and resolve escalated enrollment/eligibility issues as needed
- Acts as a technical resource to others in own function and for other internal and external customers
- Assist in updating standard procedure documents (SOPs/job aids) pertaining to electronic eligibility.
- Attend daily, weekly, and monthly Team meetings
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:
- High School Diploma / GED
- 1+ year of enrollment and electronic eligibility processing experience, within healthcare.
- 1+ year of healthcare customer service experience.
- Experience with Microsoft Word (create correspondence and work within templates), Microsoft Excel (data entry, sort / filter, and work within tables) and Microsoft Outlook (email and calendar management)
- Must be 18 years of age OR older
- Ability to work between the hours of 08:00AM - 05:00PM CST
Preferred Qualifications:
- 1+ year of COSMOS, UNET/CDB, TOM, EDD, and/or SIMON experience
- 1+ year of Billing and/or Accounts Receivable experience within healthcare.
- Experience working in an agile environment
Telecommuting Requirements:
- 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.
- Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.
Soft Skills:
- Attention to detail
- Organizational skills
- Written and oral communication skills
- Strong problem solving and/or analytic skills
- Ability to work independently
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Washington or Rhode Island Residents Only: The hourly range for this is $19.47 - $38.08 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
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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