About UHG

Careers at UnitedHealth Group


We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM


Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com


Job Category:

Enroll and Empl Contract Install



Approximate Salary:

Not Specified

Position Type:

Full Time

Enrollment / Eligibility Representative - San Francisco, CA

UHG - San Francisco, California

Posted: 11/17/2018

Energize your career with one of Healthcare’s fastest growing companies.   <?xml:namespace prefix = "o" />


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 and Performance.


The Enrollment Eligibility Representative, within Optum Eligibility Research team performs eligibility load exceptions / errors through manual update process within department standards and metrics. Positions in this function are responsible for preparing, processing and maintaining new group and member enrollments. Positions will load new group and member data into the enrollment database. Positions may also be responsible for reconciling eligibility discrepancies. Collaborate with peers and members of the business unit they support to fulfill task at hand and / or special projects. Proven ability to meet or exceed a high level of quality and production metrics. The Enrollment Eligibility Representative will be based out of our San Francisco, CA office.


Primary Responsibilities:

Respond to various types of member eligibility or group inquiries, including verify enrollment status, from internal and external customers

Work independently

Manually updating of eligibility information on a timely basis and tracking, resolving, and reporting errors and problems directly to internal / external customers

Maintain eligibility information for the claims system

Make additions, changes, and terminations to employee and dependent data

Analyze errors and taking appropriate action to resolve errors

Provide prompt, courteous and accurate replies to inquiry and or problem resolution for both internal and external customers 

Meet department turnaround times and accuracy metrics

Required Qualifications:<?xml:namespace prefix = "o" />

  • High School Diploma or GED (or higher)

  • 3+ years of experience in an office setting environment using the telephone and computer as the primary instruments to perform job duties 

  • 2+ years of customer service experience require within managed care, medical or insurance environment 

  • 3+ years of data entry experience
  • Experience working with Windows PC applications, Microsoft Excel (creating and updating spreadsheets) and Microsoft Word (creating, updating, and formatting documents)

Preferred Qualifications:  

  • 1+ years of leadership experience

  • Experience working with the following systems: Eli Admin, CDB, ISET, UNET / TOPS, CBMS, Linux, Facets and Cosmos

  • 3+ years of claim or eligibility experience 

Soft Skills:

  • Ability to navigate a computer while on the phone 

  • Ability to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each product 

  • Ability to remain focused and productive each day though tasks may be repetitive

  • Good communication, problem solving and organization skills, detail oriented

  • Ability to organize and prioritize multiple tasks and work in a team environment

  • Ability to learn new and complex computer system applications 

  • Act as a team player

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

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So, when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.


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.


Keywords: enrollment, claims, medical claims, healthcare claims, insurance claims, insurance contracts, office, UnitedHealth Group, Optum, customer service representative, customer service, CSR, Data Entry, phone support

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