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Job Details

Enrollment Specialist ES - Eligibility Operations - Irvine CA

Company name
UnitedHealth Group

Irvine, CA, United States

Employment Type

Posted on
May 19, 2020

Valid Through
Sep 01, 2020


Enrollment Specialist (ES) - Eligibility Operations - Irvine, CA','869995','!*!Energize your career with one of Healthcare’s fastest growing companies.    You dream of a great career with a great company – where you can make an impact and help people.  We dream of giving you the opportunity to do just this.  And with the incredible growth of our business, it’s a dream that definitely can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives.  We live for the opportunity to make a difference and right now, we are living it up. This opportunity is with one of our most exciting business areas: Optum – a growing part of our family of companies that make UnitedHealth Group a Fortune 6 leader. Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.Primary Responsibilities:  Takes ownership of issues. Thinks through issues and finds solutions. Looks at whole picture, not just individual piece of an issue. Ability to make sound decisions Process and troubleshoot loading batch eligibility files. Monitors and resolves file load failures Proactively monitor assigned files, being aware if file needs attention – taking ownership; taking action Understand errors resulting for the file loading process and communicate those timely and accurately to client Verify and research information in response to customer inquiry. Follow through with error issues to resolution with frequent communication for update and resolution status Proactively responding to member eligibility or group questions & verify enrollment status Runs reports and uses data to update RxClaim when needed Makes manual changes in RxClaim to accommodate client needs Assists eligibility set-up for new clients and assist with client requested changes Daily audit of assigned files, records information accurately and timely Adhere to all key audit controls and comply with all established standards associated with HIPAA, SOX, and SAS70 Ability to be proactive Ability to solve problems, follow defined processes, make decisions and apply them to problem results Demonstrated ability to be a team member, work well within a team setting Rotating Saturday work.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 higher)Healthcare industry OR Professional Office experienceStrong computer skills, including working knowledge of MS Windows and strong mouse and keyboarding skillsExperience with Microsoft Office – Using Microsoft Excel with the ability to create spreadsheets, sort and filter data; Microsoft Outlook with the ability to create and return emails on a professional level – use grammar and spell checkDemonstrated ability to write professional emailsAvailable to work 40 hours per week within the operating hours of the site with the ability to work occasional overtime including weekends, nights and holidays (New Year’s day specifically)  as business needs require Preferred Qualifications: RxClaim experience AS400 experience Prior healthcare experienceOptumRx is an empowering place for people with the flexibility to help create change. Innovation is part of the job description. And passion for improving the lives of our customers is a motivating factor in everything we do.   If you're ready to talk about groundbreaking interactions, let's talk about what happens when a firm that touches millions of lives decides to gather results from millions of prescriptions every month and analyze their impact. Let's talk about smart, motivated teams. Let's talk about more effective and affordable healthcare solutions. This is caring. This is great chemistry. This is the way to make a difference. We're doing all this, and more, through a greater dedication to our shared values of integrity, compassion, relationships, innovation and performance.  Join us and start doing your life’s best work.SMDiversity 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. Keywords: Healthcare, health care, Managed Care, Enrollment, Eligibility, Medicare, Medicaid, Customer Service, Claims','Enrollment & Eligibility','US-CA-Irvine','','OptumRx PBM Operations','Full-time','Enrollment Specialist (ES) - Eligibility Operations - Irvine, CA

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UnitedHealth Group
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