Associate Enrollment / Eligibility Representative - National Remote

Associate Enrollment / Eligibility Representative - National Remote

15 Nov 2024
Texas, Dallas / fort worth, 75201 Dallas / fort worth USA

Associate Enrollment / Eligibility Representative - National Remote

UMR, UnitedHealthcare’ s third-party administrator (TPA) solution, is the nation’s largest TPA. When you work with   UMR , what you do matters. It's that simple . . . and it's that rewarding.In providing consumer - oriented health benefit plans to millions of people; our goal is to create higher quality care, lower costs and greater access to health care. Join us and you will be empowered to achieve new levels of excellence and make a profound and personal impact as you contribute to new innovations in a vital and complex system. Opportunities are endless for your career development and advancement within   UMR  due to our record-breaking growth.Regardless of your role at  UMR , the support you feel all around you will enable you to do what you do with energy, quality, and confidence. So, take the first step in what is sure to be a fast - paced and highly diversified career.Associate Enrollment - Eligibility Representatives are responsible for preparing, processing, and maintaining member or group enrollments. Position will answer requests and questions from customers (members, providers, groups), provide expertise and support to customers, and practice superior customer service skills in all lines of communication. They may load member or group data into the enrollment database & update the database with changes. Position also responds to member eligibility or group questions and verifies enrollment status. They will be main point of contact for group customers in regard to enrollment related items. They may work with various types of member correspondence. They are also responsible for reconciling eligibility discrepancies identified by error reports, analyzing transactional data, and submitting retroactive eligibility changes.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 7:00am - 5:00pm. It may be necessary, given the business need, to work occasional overtime.You’ll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities:

Serve as primary contact as it relates to all enrollment tasks for assigned book of business, which include multiple group customers; maintain satisfied customers by providing superior service and practice attention to detail in various responsibilities.

Answer member, provider, and group customer phone calls; adhering to department expectations for answering calls and providing friendly customer service.

Follow established procedures to maintain enrollment data in applicable systems and databases based on customer request, electronic file, or internal reports; seek guidance from superiors (mentor, team-lead, supervisor) for non-standard enrollment inquiries.

After new employee ramp-up period: employee is expected to meet or exceed departmental established productivity, quality, and turn-around standards; follows department guidelines to track own work completed.

Once fully trained, take ownership of assigned workload following established procedures; frequently or periodically may require guidance from superiors to complete responsibilities.

Follows departmental guidelines to manage and prioritize own workload daily for assigned group customers to meet customer demands; may require assistance from superiors in managing or prioritizing this workload.

Read, interpret, and communicate eligibility requirements following plan guidelines.

Practice advanced follow-up skills with internal and external parties to ensure group customer expectations are attended to and that member data is accurately reflected in enrollment system at all times.

Review moderately complex error reports, analyze member enrollment data, and correct enrollment system(s) based on findings.

Resolve customer inquiries as they relate to enrollment and eligibility through all lines of communication, including e-mails and phone calls; provide customer service in a friendly and professional manner to internal/external parties; document call details in applicable system.

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

Must be 18 years of age OR older

1+years of experience helping customers resolve matters, preferably in an office environment.

Ability to navigate a computer while speaking on the phone.

Familiarity with computer and Windows PC applications

Experience with Microsoft Word (ability to sort, filter, and create simple documents), Microsoft Excel (ability to sort, filter, and create simple spreadsheets), and Microsoft Outlook (ability to create, respond to, store, and retrieve emails, and use calendar to schedule meetings)

Ability to adhere to set work schedule, Monday – Friday between the hours of 7:00am – 5:00pm; may be required to work outside of these standard business hours, including overtime to meet business need

Preferred Qualifications:

1+ years of experience in enrollment/eligibility for employer offered benefits.

1+ years of experience in a health insurance industry

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.

Must be able to connect to network with a company approved reliable high-speed internet service provider (satellite or cell tower service is not permittable)

Soft Skills:

Ability to:

thrive in a completely virtual team environment.

apply professional written and oral communication skills when communicating with customers, members, and team in a helpful and kind manner.

practice time management and prioritization skills to meet necessary deadlines with minimal supervision; seek guidance from mentors/supervisor when appropriate.

work effectively, remain focused, productive, and promote positivity at all times, through repetitive tasks, including during new system implementations and/or changing procedures.

recognize when to seek help for difficult situations from supervisor or senior enrollment representative.

identify root-cause of problems, seek/offer solutions, investigate complex matters, and discuss business practice improvements as appropriate.

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 other common office activity.

Referencing and navigating multiple computer systems and databases at one time

Position will be asked to work overtime when business needs demand.

All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy  California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C., Maryland Residents Only: The hourly range for this role is $16.00 to $28.27 per hour. 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 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.Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.#RPO

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