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Operations Service Manager

1 month ago

Clearwater, Florida, United States UnitedHealth Group Full time
About the Role

As a Customer Specialist (Service Account Manager Associate) at UnitedHealth Group, you will play a critical role in delivering exceptional customer experiences and resolving complex healthcare inquiries. This is a challenging and rewarding position that requires strong analytical and problem-solving skills, as well as excellent communication and interpersonal abilities.

Key Responsibilities
  • Manage own tasks and apply knowledge/skills to a range of complex activities
  • Demonstrate depth of knowledge/skills in own function and increased knowledge/skills in other functions such as coding, networks, integration, HRA, HCR regulations, etc.
  • Proactively identify non-standard requests and potential problems; investigate and solve using defined processes, expertise, and judgment
  • Identify potential claim and/or customer service issues during implementation and create a plan to ensure risk is minimized
  • Consult with key business partners outside of team to ensure benefit intent is understood based on source documents and output matches
  • Serve as liaison to complex customer base to manage first-level response and resolution of escalated issues with external and internal customers
  • Investigate claim and/or customer service issues as identified and communicate resolution to customers
  • Responsible for maintaining customer's medical plans installation documents
  • Responsible for testing customer benefit changes in CPS
  • Create and update HPDB's
  • Identify need for and provide specific and remedial training to processors or CFR's
  • Large claim file reviews
  • Monitor large dollar claims - for stop loss
  • Respond to SBA and external vendor audits
  • May act as resource for others
  • May coordinate other activities
Requirements
  • High School Diploma/GED
  • Must be 18 years of age or older
  • 2+ years of Customer Service experience analyzing and solving customer's problems
  • Basic proficiency with Windows computer applications, which includes ability to learn new and complex computer system applications
  • Must reside within commutable distance to Pinellas County located at 400 S Fort Harrison Ave., Clearwater, FL 33756
  • Ability to work full time, Monday - Friday. Employees are required to have flexibility to work our normal business hours of 8:00am - 5:00pm CST. It may be necessary, given the business need, to work occasional overtime.
Preferred Qualifications
  • Current or previous employment at Cigna
About UnitedHealth Group

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.