13 Aug
|
Optum
|
Hyderabad
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 Senior Enrollment & Eligibility Representative (EDM) is responsible for managing complex enrollment, eligibility, and member data management activities within the US Healthcare environment. The role involves handling customer, broker, client, and internal stakeholder inquiries through email and voice channels while ensuring accuracy, compliance, and service excellence. The incumbent will independently resolve moderately complex issues, support escalations, provide guidance to team members,
and contribute to process improvement initiatives.
Primary Responsibilities:
- EDM Operations & Data Management
- Maintain and update member records accurately in internal systems
- Perform data verification, quality checks, and audits to ensure data integrity
- Track and document all customer interactions, resolutions, and actions taken
- Identify and report data inconsistencies, operational risks, and process gaps
- Review healthcare plans, advantages, policies, and SOPs to provide accurate resolutions
- Ensure timely completion of transactions within established Service Level Agreements (SLAs)
- Maintain quality scores and productivity targets as per business expectations
- Customer & Stakeholder Support
- Handle customer, broker, employer group, and internal partner inquiries through email and voice support
- Respond professionally to member and client concerns while maintaining high customer satisf
📌 Senior Enrollment and Eligibility Representative (Hyderabad)
🏢 Optum
📍 Hyderabad