Enrollment Specialist - San Juan, PR

Posted Yesterday
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San Juan, PRI
In-Office
Junior
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
The Role
Perform full-cycle member identification, validation, enrollment and billing. Assist members with enrollment and premium payment issues, reconcile billing discrepancies, generate monthly premium bills, update payment types, and complete account reconciliations while adhering to protocols and HIPAA.
Summary Generated by Built In
Requisition Number: 2372527
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.
The Enrollment Associate is responsible for installing & implementing employers' contracts and enrolling member associated with those contracts into our system. The associate will be responsible for assisting members with issues related to enrollment and premium payments. This position acts as a liaison between member services and the enrollment plus finance departments. This position is responsible for reconciling enrollment and billing related discrepancies related to members.
Primary Responsibilities:
  • Complete the full cycle of Identification, Validation, Enrollment and Billing procedures related to members
  • Work on the customer's applications, eligibility and fallouts arising out of discrepancies in the systems
  • Ensure the accuracy and completeness of applications taken
  • Billing activity includes monthly generation of member premium bills and payments received to fulfill those bills
  • Correct all Billing discrepancies in a way that member no longer owes money
  • Changes in Payment types as requested by Member
  • Complete Account reconciliation of members post terminating the member from Services
  • Works flexibly and cooperatively under supervision with all team members
  • Completes all responsibilities according to established protocols, policies and standard practices plus adhere to regulatory compliance programs such as HIPAA
  • Other duties may apply

***ENGLISH PROFICIENCY ASSESSMENT WILL BE REQUIRED AFTER APPLICATION***
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:
  • 1+ years of experience in a production environment (metrics)
  • Proficient in MS Office with solid computer skills (e.g. multiple systems experience, keyboarding skills, Microsoft word, Power Point)
  • Proficient in verbal and written English skills
  • Ability to work 40 hours/week during standard business operating hours Monday - Friday from 8am -7pm AST (It may be necessary, given the business need, to work occasional overtime on weekends and holidays)

Preferred Qualifications:
  • Experience in medical billing /claims or enrollment
  • Healthcare experience

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is 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 is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Skills Required

  • 1+ years of experience in a production environment (metrics)
  • Proficient in MS Office and solid computer skills (multiple systems, keyboarding)
  • Proficient in verbal and written English; English proficiency assessment required after application
  • Ability to work 40 hours/week Monday - Friday 8am - 7pm AST; occasional overtime/weekends/holidays as needed
  • Pass pre-employment drug test
  • Adhere to regulatory compliance programs such as HIPAA
  • Experience in medical billing/claims or enrollment
  • Healthcare experience

What the Team is Saying

Optum Compensation & Benefits Highlights

  • Healthcare Strength Health coverage offers copay and HSA medical options with dental, vision, company‑paid life and disability, and free or low‑cost virtual visits. Feedback suggests the offering is comprehensive and competitive on paper.
  • Parental & Family Support Time off and family supports include PTO, eight paid holidays plus a floating day, six weeks paid parental leave, up to two weeks paid caregiver leave, Bright Horizons back‑up care, and adoption assistance up to $10,000. Feedback suggests these resources are meaningful for caregivers and family needs.
  • Retirement Support Savings programs include a 401(k) with employer match (after one year, vesting after two) and a 10%‑discount Employee Stock Purchase Plan. These programs bolster long‑term financial security when combined with other savings resources.

Optum Insights

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The Company
HQ: Eden Prairie, MN
160,000 Employees
Year Founded: 2011

What We Do

Optum, part of the UnitedHealth Group family of businesses, 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. At Optum, we support your well-being with an understanding team, extensive benefits and rewarding opportunities. By joining us, you’ll have the resources to drive system transformation while we help you take care of your future. We recognize the power of connection to drive change, improve efficiency and make a difference in health care. Join a team where your skills and ideas can make an impact and where collaboration is key to creating technology that produces healthier outcomes.

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Optum Offices

Hybrid Workspace

Employees engage in a combination of remote and on-site work.

Optum has three workplace models that balance the needs of the business and the responsibilities of each role. These models, core on‑site (5 days/week), hybrid (4 days/week) and telecommute or fully remote, vary by country, role and location.

Typical time on-site: Not Specified
HQEden Prairie, MN
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