Risk Management Eligibility Analyst, E&I

UnitedHealth Group • Minnetonka, MN

83d • $48,700 - $87,000

About The Position

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The Risk Management Eligibility Analyst for Employer and Individual conducts Eligibility Verification audits on in-force groups to ensure the group continues to meet the definition of a small employer as defined by their benefit contract. Audits performed verify both group and member level eligibility, participation, and consider factors including group and individual risk, common ownership, PEO, and business segment. You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Requirements

• 1+ years of experience in insurance or healthcare and/or auditing, underwriting, enrollment
• Experience meeting turnaround time and productivity goals set by management through prioritizing, organizing and utilizing good time management skills in a fast-paced environment
• Knowledge of insurance industry and products
• Intermediate level of proficiency with Microsoft Office applications
• Proven solid analytical, problem solving and critical decision-making skills

Nice To Haves

• Experience working both independently and in a team
• Knowledge of Tax Documents in an audit setting
• Knowledge of Small Business Insurance requirements
• Understands how the risk management function supports the company's goals, mission statement, and strategic objectives, and recognizes how other departments interrelate
• Knowledge and understanding of HIPAA, ACA, PHI, and PII regulation
• Proven solid verbal and written communication and customer service skills
• Demonstrated ability to exhibit solid attention to detail
• All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Responsibilities

• Conduct eligibility verification audits and reconcile tax documents for group and member level eligibility
• Communicate regularly to build and maintain solid relationships with RAE, inside sales, financial underwriters, customer service, and agents regarding case status and audit related issues
• Communicate decisions/analysis in a concise professional manner that non-auditing personnel will understand
• Interpret Group Policies, COCs, legislative and compliance regulations
• Maintain reporting and tracking database for assigned groups
• Be able to meet turnaround time and productivity goals set by management
• Maintain current knowledge and understanding of HIPAA and PHI regulations
• Takes initiative to identify and resolve issues

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Insurance Carriers and Related Activities
• Number of Employees: 5,001-10,000 employees