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UnitedHealth Group

Senior Customer Service Representative - Work From Home (112171114)

Customer Service

Customer Service

Yearly

No

Golden Valley, Minnesota, United States

If you are located within commutable distance of Golden Valley, MN, you will have the flexibility to telecommute* (work from home) as you take on some tough challenges.

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

You like working with people. Even more so, you like helping them. This is your chance to join a team dedicated to helping our members and their families every day. In this joint role as a Customer Service and Claims Representative, you'll join us on a mission to not only deliver the best customer service in the health care industry, but the best customer service. Period. Your compassion and customer service expertise combined with our support, training and development will ensure your success. This is no small opportunity. This is where you can bring your compassion for others while doing your life's best work.SM

In this role, you play a critical role in creating a quality experience for the callers that you connect with and those that you correspond with. Every interaction gives you that opportunity to improve the lives of our customers and exceed their expectations. You'll spend the majority of your day by responding to calls from our members and help answer questions and resolve issues regarding health care eligibility, claims and payments. You'll also spend a portion of your time reviewing, researching, and processing healthcare claims with the goal to ensure that every claim has a fair and thorough review.

This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of (8:00am - 5:00pm CST). It may be necessary, given the business need, to work occasional overtime. Our office is located at 6105 Golden Hills Dr. Golden Valley, Minnesota 55416.

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

Primary Responsibilities:

  • Answer incoming phone calls from customers and identify the type of assistance the customer needs (i.e. benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs)
  • Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems
  • Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow-up with the member
  • Review and research incoming healthcare claims from members and providers (doctors, clinics, etc) by navigating multiple computer systems and platforms and verifies the data/information necessary for processing (e.g. pricing, prior authorizations, applicable benefits)
  • Ensure that the proper benefits are applied to each claim by using the appropriate processes and procedures (e.g. claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/certificates)
  • Communicate and collaborate with members and providers to resolve issues, using clear, simple language to ensure understanding
  • Meet the performance goals established for the position in the areas of: efficiency, accuracy, quality, member satisfaction 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) OR equivalent work experience
  • Minimum of 3+ years of combined education, work and/or volunteer experience
  • 1+ years customer service experience in an office or professional setting
  • All new hires will be required to successfully complete the training classes and demonstrate proficiency of the material

Preferred Qualifications:

  • Health Care/Insurance environment (familiarity with medical terminology, health plan documents, or benefit plan design)
  • Social work, behavioral health, disease prevention, health promotion and behavior change (working with vulnerable populations)
  • Sales or account management experience
  • Customer Service Experience
  • Prior experience utilizing multiple systems/platforms while on a call with a member

Telecommuting Requirements:

  • Reside within commutable distance of Golden Valley, MN
  • 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

Soft Skills:

  • Demonstrated ability in using computer and Windows PC applications, which includes strong keyboard and navigation skills and learning new computer programs
  • Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations (responding in a 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 personalities
  • Proficient problem-solving approach to quickly assess current state and formulate recommendations
  • Proficient conflict management skills to include ability to resolve issues in a stressful situation and demonstrate personal resilience
  • Ability to multi-task as well as the ability to understand multiple products and multiple levels of benefits within each product
  • Ability 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 as needed

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 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.

Keywords: #RPO, #YELLOW

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