Position Description: 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. Positions in this function are responsible for providing expertise and customer service support to members as part of our UnitedHealthcare Advocate4Me model. Direct phone-based customer interaction to address complex member needs and provide recommendations on services that may help close gaps in care for the member and/or the member's family. May authorizes claims payments or refer claims to investigators for further review. Primary Responsibilities: Own problem through to resolution on behalf of the member in real time or through comprehensive and timely follow-up with the member Effectively refers and enrolls members to appropriate internal specialists and programs, based on member's needs and eligibility Respond to and resolve on the first call, customer service inquires and issues by identifying the topic and type of assistance the caller needs such as benefits, eligibility and claims, financial spending accounts and correspondence. Resolve member service inquiries related to: Medical benefits, eligibility and claims Terminology and plan design Financial spending accounts Pharmacy benefits, eligibility and claims Correspondence requests Educate members about the fundamentals of health care benefits including: Managing health and well being Maximizing the value of their health plan benefits Choosing a quality care provider and appointment scheduling Pre-authorization status Assist members in appointment scheduling to proactively address gaps in care Intervene with care on behalf of the customer to assist with appointment scheduling or connections with internal specialists for assistance when needed Research complex issues across multiple databases and work with support resources to resolve customer issues and/or partner with others to resolve escalated issues. Meet the performance goals established for the position in the areas of: efficiency, call quality, customer satisfaction, first call resolution and attendance Maximizes use of community services, support programs, and resources available to memberExtensive work experience within own function.Work is frequently completed without established procedures.Works independently.May act as a resource for others. May coordinate others' activities.
Required Qualifications:High school diploma / GED (or higher) OR 10+ years of equivalent working experienceBilingual fluency in English and South Asian (speak, read, and write) requiredProficient in translating healthcare-related jargon and complex processes into simple, step-by-step instructions customers can understand and act uponAbility to work regularly scheduled shifts within our hours of operation including the training period, where lunches and breaks are scheduled, with the flexibility to adjust daily schedule, and work over-time and / or weekends, as neededAll new hires will be required to successfully complete the Customer Service training classes and demonstrate proficiency of the material1+ years prior experience in an office setting, call center setting or phone support roleModerate Proficiency with Microsoft Word - Creating and editing, Excel - Creating and editing, Assets: Undergraduate Degree Soft Skills:Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations (responding in respectful, timely manner, consistently meeting commitments)Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests and identify the current and future needs of the member Flexibility to customize approach to meet all types of member communication styles and personalitiesProficient problem solving approach to quickly assess current state and formulate recommendationsProficient conflict management skills to include ability to resolve issues in a stressful situation and demonstrating personal resilienceThere are several steps in our hiring process - it's a thorough process because we want to ensure the best job and culture fit for you and for us. In today's ultra-competitive job market, the importance of putting your best foot forward is more important than ever. And you can start by completing all required sections of your application. (i.e. profile, history, certifications and application/job questions). Once you submit your resume, you'll receive an email with next steps. This may include a link for an on-line pre-screening test(s) (or what we call an assessment) that we ask you to complete as part of our selection process. You may also be asked to complete a digital video interview, but we will offer full instructions and tips to help you. After you have completed all of these steps, you can check on the status of your application at any time, but you will also be notified via e-mail. http://uhg.hr/OurApplicationProcessCareers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of healthcare. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.SM 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.Key Words: customer service representative, customer service, CSR, UnitedHealth Group, call center, UnitedHealthcare, health care, office, phone support, training class, South Asian, bilingual
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.