Enrollment and Eligibility Representative

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.

If it sounds too good to be true, consider this: Through our family of businesses and a lot of inspired individuals, we're building a high-performance structure that works better for more people in more ways.

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

• Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regard to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so

Required Qualifications:

• An education level of at least a high school diploma or GED OR 10 years of equivalent working experience
• instruments to perform job duties
• Available to work 40 hours per week within the operating hours of the site
• Stable work experience
• Moderate work experience within own function
• Solid computer skills, including working knowledge of MS Windows and solid mouse and keyboarding skills

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 compute
• Service center environment with moderate noise level due to Representatives talking, computers, printers, and floor activity

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.