Enrollment Quality Analyst
About The Position
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. For all hires in Minneapolis, Virginia, Maryland, or Washington, D.C. area, you will be required to work in the office for a minimum of four (4) days per week. 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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The Benefit Audit Teams serve as independent quality assurance partners, dedicated to enhancing client experience and operational accuracy across pharmacy benefit services. Benefit Audit Team specializes in evaluating benefit coding to ensure accurate configuration within the RxClaim system. BAT exclusively validates and tests the work performed by the Benefit Operations Management (BOM) team, safeguarding the integrity of benefit setups and supporting compliance and operational excellence.
Requirements
- High School Diploma / GED OR equivalent work experience
- Must be 18 years of age OR older
- 1+ years of claims OR collections experience
- 1+ years of customer service experience analyzing and solving customer problems
- Experience working in the healthcare industry
- Proficiency with computer and Windows PC applications
- Ability to work full time (40 hours / week), 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 local time. It may be necessary, given the business need, to work occasional overtime.
Nice To Haves
- 1+ years of Rxclaim experience
- Intermediate experience with Microsoft Excel (macros, advanced formulas, vlookup, pivot tables)
Responsibilities
- Primary focus is on auditing high-complexity coding requests across various lines of business
- Identifying and submitting coding errors for resolution
- Assisting with team-related projects as directed by leadership
- Assisting with the development of new hires by providing audit-related support as well as editing and creating internal process documentation as requested
- Assisting with audit inquiries submitted by team members
- Beta testing
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
