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Bilingual (English / Spanish) Service Account Manager - Miami, FL

2 months ago

Doral, United States UnitedHealth Group Full time

Cuando se trata de salir adelante y tienes la voluntad de ganar, vamos a llamarlo gran potencial de carrera Imagine being able to get answers to your health plan questions from someone who speaks the same language as you do. Or, the opposite, not being able to get the answers. At UnitedHealth Group, we want our customers to get those answers by speaking to one of our Bilingual Representatives. If you're fluent in English and Spanish, we can show you how to put all of your skills, your passions and your energy to work in a fast - growing environment.

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities, and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us and start doing your life's best work.SM

The purpose of the Onsite Service Account Manager is to delight our customers by resolving issues through timely and accurate problem identification, routing issues to the appropriate department or account manager as needed, and then delivering resolution or status of issues requiring additional research. This position will serve Miami-Dade County Public Schools.

You will service Miami-Dade County Public Schools' UnitedHealthcare Dental products (2 PPOs and 2 HMOs). You will report to the client location in downtown Miami on a daily basis. You will answer questions about dental benefits, authorizations, pre-treatment plans, eligibility, as well as work on Eligibility File Error Reports, and educate members on their UHC dental portal and benefits. You will also work closely with UHC account management as well as the client's benefits team.

Your role is key in maintaining the relationship between UHC and M-DCPS. You will act as a dual citizen, supporting the UHC Account Management Team and Health Plan as well as the client's Benefits Team.

This position is full time Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 4:30 pm EST. It may be necessary, given the business need, to work occasional overtime. Our office is located at 1501 NE 2nd Ave, Suite 335, Miami, FL, 33132.

We offer weeks of paid training. The hours during training will be 8:00 am to 4:30 pm EST, Monday - Friday.

Primary Responsibilities:

  • Servicing with UnitedHealthcare Values: Compassion, Integrity, Relationships, Innovation, and Performance
  • Serve as the liaison to customer and members by managing first level response and resolution of escalated issues
  • Quickly and accurately identify and assess customer issues and resolve in real - time
  • Identify and resolve operational problems using defined processes, expertise and judgment
  • Investigate claim and / or customer service issues as identified and communicate resolution to customers
  • Resolve claim or eligibility issues real time or in an expedited manner
  • Provide feedback to team members regarding improvement opportunities
  • Provide expertise and customer service support to members, customers, and providers
  • Refer directly to appropriate UHC Clinical Programs
  • Quickly establish rapport relating to the customer and membership in a polite, positive, and courteous manner
  • Project patience, empathy, caring, and sincerity in voice tones and words
  • Express thoughts and information clearly and succinctly
  • Handle irate callers in a manner that defuses their emotion
  • Achieve quality and efficiency objectives
  • Maintain proficiency in all technical applications (technical skills and system knowledge)
  • Comply with all current policies, procedures, and workflows
  • Apply knowledge / skills to complex activities
  • Anticipate customer needs and proactively identify solutions
  • Solve complex problems independently when able; proactively identify new solutions to problems
  • Plan, prioritize, organize, and complete work to meet established objectives

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
  • Must be 18+ years of age or older
  • 3+ years of customer service experience in healthcare/medical or dental insurance
  • Experienced with Microsoft Excel, Microsoft Word, and Microsoft Outlook
  • Knowledge of medical or dental terminology
  • Must be available to attend open enrollment activities locally during the week and/or weekends
  • Bilingual fluency in English and Spanish
  • Ability to work Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 4:30 pm EST. It may be necessary, given the business need, to work occasional overtime.

Preferred Qualifications:

  • High-level understanding of claim processing
  • Working knowledge of ISET (i.e reviewing claim issues and eligibility)
  • Experience with UNET based systems (CES, TOPS, eServices, etc.)
  • Experience in Claims Payment, Claims Adjustment and/or enrollment

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. 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. Candidates are required to pass a drug test before beginning employment.

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