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Enrollment / Eligibility Representative - Irvine, CA

UnitedHealth Group


Location:
Irvine, CA
Date:
09/05/2017
2017-09-052017-10-04
Job Code:
1784193
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Job Details


Enrollment / Eligibility Representative - Irvine, CA(Job Number:729543)
Description

Position Description:

 

Working in Operations at UnitedHealth Group is one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.

 

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.

 

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

  • Conduct audits and provides feedback to reduce errors and improve processes and performance 

  • Acts as a liaison between the client management and development teams 

  • Process and troubleshoot batch eligibility files 

  • Verify distribution of all necessary outbound reports 

  • Coordinate eligibility set - up for new clients and assist with client requested changes 

  • Verify and research information in response to customer inquiry

  • Preparing, processing, and maintaining new member or group enrollments

  • Proactively responding to member eligibility or group questions & verify enrollment status

  • Reconciling eligibility discrepancies, analyzing transactional data & submitting retroactive eligibility changes

  • Participates in creating process documentation

  • Adhere to all key audit controls and comply with all established standards associated with HIPAA, SOX, and SAS70


Job Enrollment & Eligibility
Primary Location US-CA-Irvine
Other Location 
Organization OptumRx Claims Operations
Schedule Full-time
Number of Openings 1
Apply on the Company Site

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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