Positions in this function are responsible for preparing, processing and maintaining new member or group enrollments. Positions may load new member or group data into the enrollment database & update the database with changes. Positions may also respond to member eligibility or group questions & verify enrollment status. Positions may work with various types of member correspondence. Positions may also be responsible for reconciling eligibility discrepancies, analyzing transactional data & submitting retroactive eligibility changes. Positions may also be responsible for inventory control of member and group transactions. *Employees in jobs labeled with ‘SCA’ must support a government Service Contract Act (SCA) agreement.
- Moderate work experience within own function.
- Some work is completed without established procedures.
- Basic tasks are completed without review by others.
- Supervision/guidance is required for higher level tasks.
This position is full-time, Monday - Friday. Employees are required to work our normal business hours of 7:00am – 3:30pm PST. It may be necessary, given the business need, to work occasional overtime or weekends.
We offer weeks of on-the-job training. The hours of the training will be aligned with your schedule.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
- Researching errors by comparing enrollment error reports against system information along with CMS (Center for Medicare and Medicaid Services) records.
- Sending correspondence to members or CMS (Center for Medicare and Medicaid Services) to gather information or provide updates for corrections.
- Reconciling reports
- Performing basic clerical functions with proficient PC skills
- Analytical and Researching techniques to trend or quantify projects
- Initiate and assist with developments/changes to increase or change quality and productivity
- Preparing, processing, and maintaining new member or group enrollments
- Responding to member eligibility or group questions & verify enrollment status
- Working with various types of member correspondence
- Reconciling eligibility discrepancies, analyzing transactional data & submitting retroactive eligibility changes
- Inventory control of member and group transactions
- Ensuring client files are properly loaded in RxClaim NextGen
- Communicate group and member errors to clients
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 education / GED OR equivalent experience.
- Must be 18 years or older
- 5+ year of experience in an office setting environment using the telephone and computer as the primary instruments to perform job duties
- Authorization to work in the United States
- Available to work 40 hours per week within the operating hours of the site
- Prior stable work experience
- Computer skills, including working knowledge of Microsoft Windows and mouse and keyboarding skills
- Ability to work New Years Day (1/1)
- Ability work our normal business hours of 7:00am – 3:30pm PST. It may be necessary, given the business need, to work occasional overtime or weekends.
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.
Physical Requirements and Work Environment:
- Frequent speaking, listening using a headset, sitting, use of hands/fingers across keyboard or mouse, handling other objects, long periods working at a computer
- Service center environment with moderate noise level due to Representatives talking, computers, printers, and floor activity
- All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
The hourly range for this role is $16.88 to $33.22 per hour based on full-time employment. 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.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
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