Requisition number: 2393717
Job category: Enrollment
This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
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 6:00 am - 6:00 pm PST. It may be necessary, given the business need, to work occasional overtime.
We offer weeks of paid training. The hours of the training will be based on schedule or will be discussed on your first day of employment.
Primary Responsibilities:
Understand how benefit configuration ties directly to claims processing payment rules
Utilize knowledge of benefit plans and documents to gather details to create/update applicable product configuration elements
Collaborate with stakeholders to gather, assess, interpret and document customer needs and requirements
Identify and analyze system issues to provide solutions
Design, configure and build various product / benefit components
Research claims issues to determine configuration gaps, update configuration as applicable
Audit configuration against benefit plan requirements / EOC, etc., verify configuration following source documentation
Work with minimal guidance and supervision
Serve as a resource to other team members
Consistently meet established productivity, schedule adherence, and quality standards while maintaining expected attendance
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 equivalent work experience
Must be 18 years of age OR older
2+ years of experience with Epic-Tapestry, EZ-CAP, Xcelys, IDX, or FACETS
2+ years of experience working with Medicare benefit configuration, claims issue resolution or other areas of configuration
Constantly meet established productivity, schedule adherence, and quality standards while maintaining good attendance
Oral and written communication skills
Aptitude for working in a production driven environment
To be a self-starter and able to work independently
Ability to multi-task
Ability to work in a fast-paced, dynamic, rapidly changing environment
Proficiency in Microsoft Office Suite
Computer proficiency including, but not limited to, ability to learn new computer system applications
Ability to work 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 6:00 am - 6:00 pm PST. It may be necessary, given the business need, to work occasional overtime
Preferred Qualifications:
2+ years of health insurer experience with medical plan case installation or benefit plan building
2+ years of health insurer experience handling provider billing/co-payments/co-insurance
2+ years of health insurer experience resolving provider claim issues
Experience with Medicare medical benefit plans
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.
Soft Skills:
Interpersonal Skills - ability to deal and work with people with different backgrounds. Demonstrated ability to build and maintain long term internal business relationships
Decision-Making Skills - capable of arriving at the appropriate decisions after weighing the pros and cons of all the options
Communication Skills - excellent verbal and written communication skills in addition be a good listener to give value to the opinion and suggestion of others
Accountability - Takes ownership of tasks, performance standard and quality results. Maintains necessary attention to detail to achieve high level performance
Problem Solving - Solution Driven Approach Skills - demonstrate ability to review problem, troubleshoot root cause issues and determine path to resolution
Flexible - Able to work effectively in a changing environment and contribute innovative ideas
Accuracy and Efficiency - Excellent time management and organizational skills balancing multiple priorities. Accurate when processing detailed tasks while meeting deadlines
Self-starter, able to independently, drive work and prioritize work with minimal oversight
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $29.00 to $52.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
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 help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.
UnitedHealth Group and its affiliated brands are an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
