Enrollment and Eligibility Representative

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.

Primary Responsibilities:

• Should be able to meet standard performance targets like Quality, TAT, NPS, etc.
• Ability to clearly communicate and resolve customer/broker queries either through email/call
• Should have good interpretation of SOP guidelines
• Should work independently with minimum supervision and adhere to all process guidelines
• Ability to communicate process failures and propose remediation, as well as developing remediation plans in all variety of mediums (verbal, writing, PowerPoint)
• Is eager to take on more responsibilities and should be able to execute the adhoc tasks
• Maintains expert level knowledge of Eligibility process and provide inputs to Leadership on any process gaps that exist
• Ensure compliance with internal policies and procedures, external regulations and information security standards
• Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regard to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so

• Skills
  • Proven excellent communication skills in both verbal & written
  • Ability to work in permanent night shift and extended shift as per business need
  • Proven attention to detail - should be quality focused
  • Good Team player and ability to work with minimal supervision
  • Should have a minimum understanding of Healthcare terminologies/concepts
  • Solid computer skills, including working knowledge of MS applications and keyboarding skills
  • Moderate proficiency with Microsoft Word and Excel
  • Should be flexible and adapt basis business need