UnitedHealth Group Hiring for Customer Service Representative – National Remote at Dallas, TX Full Time

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

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

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 7am – 7pm 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.

Primary Responsibilities:

• Respond to and resolve, on the first call, customer service inquiries and issues from a number of sources (Provider, Member, Customer)
• Research complex issues using multiple UMR proprietary applications and databases and work with appropriate internal support resources to resolve customer issues and/or partner with Supervisor to resolve escalated issues
• Help members locate providers, understand their benefit plan and answer questions related to processed claims
• Collaborate effectively with multiple internal partners to ensure issues are resolved and thoroughly communicated to providers, members, and customers in a timely manner.
• Research and dissect complex prior authorization and claim issues and take appropriate steps to resolve identified issues to avoid repeat calls, escalations, and provider dissatisfaction.
• Ensure that the proper benefits are applied to each claim by using the appropriate processes and procedures to adjudicate complex claims (e.g. claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/certificates)
• Strong multitasking to effectively and efficiently navigate more than XX systems to extract necessary information to resolve and
• Meet the performance goals established for the position in the areas of: quality, productivity, 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)
• 1+ years of customer service experience analyzing and solving customer’s concern
• Ability to work 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 7am – 7pm CST. It may be necessary, given the business need, to work occasional overtime.

Preferred Qualifications

• 2+ years customer service OR experience in the healthcare industry

Soft Skills:

• Verbal/Written Communication
• Active Listening
• Negotiation
• Empathy/Sensitivity
• Patience/Resilience
• Agility/Flexibility
• Conflict Resolution
• Cultural Sensitivity
• Effective time and resource management
• Disability & Diversity Awareness

Telecommuting Requirements:

• 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

Careers with UnitedHealthcare. Work with a Fortune 5 organization that’s serving millions of people as we transform health care with bold ideas. Bring your energy for driving change for the better. Help us improve health access and outcomes for everyone, as we work to advance health equity, connecting people with the care they need to feel their best. As an industry leader, our commitment to improving lives is second to none.

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.

#RPO #YELLOW