Client Service Rep, Call Center

1 week ago

Green Bay, Wisconsin, United States UnitedHealth Group Full time

You'll enjoy the flexibility to telecommute from anywhere within the U.our goal is to create higher quality care, lower costs and greater access to health care.

Regardless of your role at UMR , the support you feel all around you will enable you to do what you do with energy, quality, and confidence.

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.

The Customer First Representative is a hybrid role in which you will handle Calls and Claims while delivering the best customer service in the healthcare industry to our members.

Your compassion and customer service expertise combined with our support, training and development will ensure your success.

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.

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 7:00am - 8:00pm CST.

It may be necessary, given the business need, to work occasional overtime.
We offer an initial 6 weeks of paid training related to taking calls. The hours during training will be 8:00am to 4:30pm CST, Monday - Friday. Within 6-8 months after the initial call training, you will attend an additional 5 weeks of claims training. Training will be conducted virtually from your home.
*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
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

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.

High School Diploma / GED OR equivalent working experience
~1+ years of experience in a related environment (i.e. office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools
~ Proficiency with Windows PC applications, which includes the ability to navigate multiple programs and learn new and complex computer system applications
~ Must be 18 years of age OR older
~ Ability to work regularly scheduled shifts within our hours of operation (7:00am- 8:00pm CST Monday - Friday) 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 needed
~ 1+ years experience in customer service call center within the healthcare insurance industry
~ Experience working with medical claims processing
~ Familiarity with medical terminology, health plan documents, or benefit plan design
~ Prior experience utilizing multiple systems/platforms while on a call with a member

Telecommuting Requirements:
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.

Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests and identify the current and future needs of the member
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Washington or

Rhode Island Residents Only:
The hourly range for this is $16.55 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable.

In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).


Application Deadline:

_ This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone.

Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes.

We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

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.

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