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Job Details


UnitedHealth Group

Customer Service Representative - Work from Home (109571548)

Customer Service

Customer Service

Yearly

No

Minneapolis, Minnesota, United States

If you are located within the state of Minnesota, North Dakota, South Dakota, Wisconsin, Iowa, and North Carolina, you will have the flexibility to telecommute* (work from home) as you take on some tough challenges.

Energize your career with one of Healthcare’s fastest growing companies.

You dream of a great career with a great company – where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it’s a dream that definitely can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.

This opportunity is with one of our most exciting business areas: Optum – a growing part of our family of companies that make UnitedHealth Group a Fortune 5 leader.

Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.

This position is full-time. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8am - 5pm CST. It may be necessary, given the business need, to work occasional overtime.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

In this role, you'll be empowered to compassionately deliver an exceptional experience to between 50 to 70 callers per day, always remembering that there is a real person on the other end of the phone who is looking for help, guidance, and support. Every phone call gives you that opportunity to improve the lives of our customers and exceed their expectations. You’ll spend your day by responding to calls from our members and help answer questions and resolve issues regarding health care eligibility, claims and payments. At the end, you’ll know you performed with integrity and delivered the best customer service experience making your customers feel better because they talked to you.

Primary Responsibilities:

  • Research, identify and obtain data/information needed to help process claims or resolve claims issues (e.g., verify pricing, prior authorizations, applicable benefits)
  • Ensure that proper benefits are applied to every claim
  • Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow - up with the member or provider
  • Apply knowledge of customer service requirements to process claims appropriately (e.g., Service Level Agreements, performance guarantees)
  • -Identify and apply knowledge of new plans/customers to process their claims appropriately -Identify and resolve claims processing errors/issues and trends, as needed (e.g., related to system configuration, network, eligibility, data accuracy, vendor-related, provider)
  • Research complex issues across multiple databases and work with support resources to resolve customer issues and / or partner with others to resolve escalated issues
  • Provide education and status on previously submitted pre - authorizations or pre - determination requests
  • Meet the performance goals established for the position in the areas of: efficiency, call quality, customer satisfaction, first call resolution and attendance

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

  • High School Diploma / GED (or higher)
  • 2+ years of experience in customer service role
  • Experience in Microsoft Word – data entry and documentation creation
  • Experience in Microsoft Excel – data entry, sorting, creating / modifying spreadsheets

Preferred Qualifications:

  • Bachelor's Degree (or higher)
  • 1+ years of Call Center experience
  • Behavioral Health experience
  • Claims customer service experience
  • Experience with medical terminology

Telecommuting Requirements:

  • Reside within the state of Minnesota, North Dakota, South Dakota, Wisconsin, Iowa
  • Required to have a dedicated work area established that is separated from other living areas and provides information privacy
  • Ability to keep all company sensitive documents secure (if applicable)
  • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at https://uhg.hr/transitioning-military

Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible. https://uhg.hr/vet

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health - related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do 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.

Keywords: #RPO, #YELLOW

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