Enrollment/Eligibility Representative - New York, NY
UnitedHealth Group - New York, NY

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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.(sm)

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.
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
  • Problem resolution skills are highly desired
  • Moderate work experience within own function.
  • Some work is completed without established procedures.
  • Basic tasks are completed without review by others.
  • Supervision/guidance is required for higher level tasks.
  • HS Diploma/GED
  • Hours of operation: Monday thru Friday 9 AM to 5 PM (Over time and weekends are as needed based on the needs of the clients)
  • Associates degree or 2+ years of equivalent work experience in an insurance company
  • Strong English, written and oral communication skills
  • Organization and interpersonal skills
  • 1+ year working with the chronically ill, elderly, disabled, and or frail population is a must

  • Bilingual Preferred in either English and Spanish, Russian, or Chinese (Cantonese or Mandarin)

  • Intermediate skills in Word, Excel, and PowerPoint
  • Understanding of Medicaid and Medicare regulations preferred

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 computer
  • Service center environment with moderate noise level due to Representatives talking, computers, printers, and floor activity
UnitedHealthcare Community & State is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.

If you're ready to help make health care work better for more people, you can make a historic impact on the future of health care at UnitedHealthcare Community & State.

We contract with states and other government agencies to provide care for over two million individuals. Working with physicians and other care providers, we ensure that our members obtain the care they need with a coordinated approach.

This enables us to break down barriers, which makes health care easier for our customers to manage. That takes a lot of time. It takes a lot of good ideas. Most of all - it takes an entire team of talent. Individuals with the tenacity and the dedication to make things work better for millions of people all over our country.

You can be a part of this team. You can put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.

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UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier...