Associate Enrollment and Eligibility Representative

This position is national remote, offering the flexibility to telecommute from anywhere within the U.S. For hires in Minneapolis, Virginia, Maryland, or Washington, D.C., you will be required to work in the office a minimum of four (4) days per week.

About the role

Optum is a global organization delivering care aided by technology to help millions live healthier lives. In this role, you will directly improve health outcomes by connecting people with care, pharmacy benefits, data, and resources. You’ll join a culture guided by inclusion, with comprehensive benefits and career development opportunities.

This is a full-time position, Monday through Friday. Employees must have flexibility to work any 8-hour shift during business hours (7:00 am – 5:00 pm PST) and may need to work occasional overtime. The role includes 2 weeks of paid virtual training, scheduled 7:00 am to 5:00 pm PST, Monday through Friday.

Responsibilities

• Research errors by comparing enrollment error reports against system information and CMS (Center for Medicare and Medicaid Services) records.
• Send correspondence to members or CMS to gather information or provide updates for corrections.
• Reconcile reports and perform basic clerical functions with proficient PC skills.
• Apply analytical and research techniques to trend or quantify projects.
• Initiate and assist with developments or changes to improve quality and productivity.
• Prepare, process, and maintain new member or group enrollments.
• Respond to member eligibility or group questions and verify enrollment status.
• Work with various types of member correspondence.
• Reconcile eligibility discrepancies, analyze transactional data, and submit retroactive eligibility changes.
• Manage inventory control of member and group transactions.

Requirements

• High School Diploma / GED or equivalent work experience.
• Must be 18 years of age or older.
• 1+ years of experience in an office setting using telephone and computer as primary tools.
• 1+ years of customer service experience.
• Stable work history.
• Computer skills, including working knowledge of Microsoft Windows, mouse, and keyboarding.
• Ability to work full-time, Monday through Friday, with flexibility for any 8-hour shift during business hours (7:00 am – 5:00 pm PST) and occasional overtime.

Preferred Qualifications

• Healthcare experience.

Telecommuting Requirements

• Ability to keep all company-sensitive documents secure.
• Dedicated work area separated from other living areas, ensuring information privacy.
• Must live in a location that can receive a UnitedHealth Group-approved high-speed internet connection or leverage existing high-speed service.

Physical and Work Environment

• Frequent speaking, listening using a headset, sitting, use of hands/fingers for keyboard or mouse, and 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 remote employees must adhere to UnitedHealth Group’s Telecommuter Policy.

Pay

The hourly pay for this role ranges from $18 to $32 per hour based on full-time employment, depending on factors such as local labor markets, education, work experience, and certifications. We comply with all minimum wage laws as applicable.

Benefits

In addition to salary, we offer a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution (all benefits are subject to eligibility requirements).