EDI Specialist - Financial Protection - Portland, ME

Unitedhealth Group Inc. Portland , ME 04101

Posted 2 months ago

Welcome to 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. SM

The Financial Protection EDI (Electronic Data Interchange)Specialist is responsible for the successful onboarding and ongoing support of EDI eligibility files within the life, disability and supplemental health product segment on the FACETS platform. The EDI Specialist will engage enrollment vendors to communicate file requirements, plan structure and product rules with the intended goal of partnering to create an accurate and complete ongoing enrollment file. The EDI Specialist will be accountable for testing files prior to production as well as testing and providing quality/issue support for those groups that are actively in production. The EDI Specialist will be required to partner with enrollment vendors, brokers, sales and internal partners to onboarding and provide ongoing production support for active groups.

Primary Responsibilities

  • Provide ongoing production support for active EDI groups within Financial Protection

  • Partner and communicate with external enrollment vendors to resolve issues

  • Partner with internal stakeholders and billing teams to ensure accurate and timely group billing

  • Work with case setup teams to identify and document group structure

  • Leverage internal audit tools to validate integrity of EDI Files

  • Partner and communicate file requirements with vendors

  • Proactively identify process efficiencies within workflow

  • Manage ongoing EDI production workflow and tracking tool

Required Qualifications

  • High School Diploma / GED (or higher)

  • 2 Years of experience in a customer facing role

  • 2 Years of experience in Healthcare / Insurance Industry

  • Experience with Microsoft Word (create and edit documents)

  • Experience with Microsoft Excel (create and edit spreadsheets and sort, filter, and work with formulas / pivot tables)

Preferred Qualifications

  • Experience with enrollment and/or EDI

  • Experience with Life and/or Disability Insurance

  • Experience with relevant systems/platforms (e.g. Facets and Serena Business Manager)

Soft Skills

  • Strong attention to detail and excellent organizational skills

  • Must have the ability to multi-task in a fast paced and deadline driven environment

  • Interpersonal, performance management, problem solving and organizational skills

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 14 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.

Diversity creates a healthier atmosphere: 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: UHG, UHC, healthcare enrollment, EDI, life and disability, health insurance, Facets, Serena Business Manager


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EDI Specialist - Financial Protection - Portland, ME

Unitedhealth Group Inc.