Coordination of Benefits Representative - Duluth, MN (Telecommute)

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.

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. 

The Coordination of Benefits Representative in this function is 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. Employees in jobs labeled with SCA must support a government Service Contract Act (SCA) agreement.

Primary Responsibilities:

• Research errors by comparing enrollment error reports against system information along with CMS (Center for Medicare and Medicaid Services) records
• Send correspondence to members or CMS (Center for Medicare and Medicaid Services) to gather information or provide updates for corrections
• Reconcile reports
• Perform basic clerical functions with proficient PC skills
• Perform analytical and researching techniques to trend or quantify projects 
• Initiate and assist with developments / changes to increase or change quality and productivity
• Prepare, process, and maintain new member or group enrollments
• Respond to member eligibility or group questions & verify enrollment status
• Work with various types of member correspondence
• Reconcile eligibility discrepancies, analyze transactional data & submit retroactive eligibility changes
• Inventory control of member and group transactions
• 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

Required Qualifications:

• High School Diploma / GED (or higher)
• 1+ years of experience in an office setting environment using the telephone and computer as the primary instruments to perform job duties
• Prior stable work history
• Strong computer skills, including working knowledge of Microsoft Windows such as Microsoft Word (creating and editing documents) and Microsoft Excel (general spread sheet navigation, data entry and sorting data) as well as strong mouse and keyboarding skills

Preferred Qualifications:

• Understanding insurance EOB's, enrollment & eligibility of insurance claims
• Microsoft Excel skills in running macros and hotkeys (i.e. Control Alt Delete and other functions)

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 at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in healthcare here. We serve the healthcare needs of low income adults and children with debilitating illnesses such as Cardiovascular Disease, Diabetes, HIV / AIDS and High - risk Pregnancy. Our holistic, outcomes - based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive Healthcare, Community, and Government partners to heal healthcare and create positive change for those who need it most. This is the place 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: Healthcare, Claims, Enrollment, Claims Processing, Eligibility, Medicaid, Medicare, Duluth, MN