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Optum

Associate Enrollment and Eligibility Representative

Posted An Hour Ago
Be an Early Applicant
In-Office
Dallas, TX
16-29 Hourly
Junior
In-Office
Dallas, TX
16-29 Hourly
Junior
Researches and reconciles enrollment and eligibility discrepancies using system reports and CMS records. Processes member and group enrollments, verifies eligibility, submits retroactive changes, manages transaction inventory, and responds to member or group questions. The role also sends correspondence, performs clerical and analytical tasks, trends project data, and supports quality and productivity improvements. It is a full-time remote service-center position with paid virtual training and occasional overtime.
The summary above was generated by AI
Requisition Number: 2388481
This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. For all hires in Minneapolis, Virginia, Maryland, or Washington, D.C. area, you will be required to work in the office for a minimum of four (4) days per week.
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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
This position is full-time, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00 am - 5:00 pm PST. It may be necessary, given the business need, to work occasional overtime.
We offer 2 weeks of paid training. The hours will be an 8-hour shift schedule during our normal business hours of 7:00 am - 5:00 pm PST. Training will be conducted virtually from your home.
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
  • Other duties as assigned

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 OR equivalent work experience
  • Must be 18 years of age OR older
  • 1+ years of experience in an office setting environment using the telephone and computer as the primary instruments to perform job duties
  • 1+ years of customer service experience
  • Consistent and reliable employment history
  • Computer skills, including working knowledge of Microsoft Windows and strong mouse and keyboarding skills
  • Ability to work full-time, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00 am - 5:00 pm PST. It may be necessary, given the business need, to work occasional overtime.

Preferred Qualifications:
  • Healthcare experience

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 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
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $16 - $29 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
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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