Senior Complex Customer Care Representative - National Remote
Company: UnitedHealth Group
Location: Los Angeles
Posted on: January 28, 2023
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Job Description:
You'll enjoy the flexibility to telecommute from anywhere within
the U.S. as you take on some tough challenges. Optum is a global
organization that delivers care, aided by technology to help
millions of people live healthier lives. The work you do with our
team will directly improve health outcomes by connecting people
with the care, pharmacy benefits, data and resources they need to
feel their best. Come make an impact on the communities we serve as
we help advance health equity on a global scale. Here, you will
find talented peers, comprehensive benefits, a culture guided by
diversity and inclusion, career growth opportunities and your
life's best work. SM This position is full-time, Monday - Friday.
Employees are required to work our normal business hours of 7am -
10pm CST. It may be necessary, given the business need, to work
occasional overtime or weekends. All Telecommuters will be required
to adhere to UnitedHealth Group's Telecommuter Policy. Primary
Responsibilities: Support inbound and outbound calls with an
emphasis on excellent customer service in a high volume call center
environment. Own member issues, questions, concerns, and see them
through to resolution. Respond to members and providers in a polite
and courteous manner,with patience, empathy, care, compassion, and
sincerity in voice tone and pace. Assist members with medical and
pharmacy benefits, medical plan overview, behavioral health
inquiries, claims, provider search and prior authorization.Provide
member education on HAS, FSA, HRA, and other financial accounts.
Serve as a Health Care Advisor, going above and beyond for
consumers, creating a memorable consumer experience, and providing
expert, proactive service to members by:Finding creative ways to do
more than what the member expectsDelighting each member by meeting
their unexpressed needsLeaving each person feeling confident and
cared for Provide services such as:Education to help simplify the
healthcare system and validate members understanding of next best
actionsAdvise members in choosing healthcare providers that meet
and exceed consumer needsEducate members on clinical and wellness
resources they can take advantage of to manage a health
condition/disease or reach a wellness goalProvide education to
members to assist in understanding benefits, terminology, claim
resolution and Explanation of Benefit interpretationServe as an
advocate by responding to, resolving and escalating complex claim
issues with internal and external resources Initiate telephone
calls to internal sources, membership, providers, and other claim
payers to gather data and determine resolution to claim issuesRefer
qualified members into Wellness and clinical programsSolve problems
systematically, using sound business judgment, and following
through on commitmentsConsistently meet established productivity,
schedule adherence, meeting metric expectations, and quality audit
standardsWork with cross carries to ensure member follow up and
resoultuon. (cross carrier functions) Work with providers and plans
to help ensure critical info is being relayed timely between the
plan and the provider. Support multiple clients and their
indiviuals expectations. Help Secure establishing patient
appointments for the first time visit to the PCP.Provide community
resources once internal resources have been exhausted
(e.g.Financical assistant programs, Medical assistant program
resources)Work with Network management to ensure panel request are
up to date and when providers are not confirming to the contract
(e.g.balance billing) 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: Associate's Degree (or higher) in related
field2+ years of experience in a Call and Contact Center within the
Healthcare Field/Financial Services, Advocacy Service, Customer
Service, Sales, and Hospitality.Familiarity with computer and
Windows PC applications, which includes the ability to learn new
and complex computer applications and apply their use while on the
phone Proficiency with Microsoft Office (Excel, Word, Outlook, and
PowerPoint) is required. Preferred Qualifications: Bachelor's
degree (or higher) and background in the health care
industryExperience with medical or health terminology Multi-lingual
candidates (e.g. English/Spanish) Telecommuting Requirements:
Required to have a dedicated work area established that is
separated from other living areas and provides information
privacyAbility 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 Skills and Experience Ability
to understand and effectively explain complex benefit
plans.Excellent customer service, interpersonal, communication, and
organizational skills. Ability to overcome objections and persuade
members to take action / change behaviorFlexibility to customize
approach to meet all types of member communication styles and
personalitiesExcellent interpersonal, written and verbal
communication skills.Excellent problem solving and critical
thinking skills to resolve complex healthcare issues.Strong
attention to detail Quality focusedAbility to use multiple systems
while assisting consumersExcellent conflict management skills
includingAbility to resolve issues under stressDiffuse conflict and
member distressAbility to organize and prioritize tasks efficiently
Excellent interpersonal, written and verbal communication skills
Ability to excel in a fast-paced work environment where constant
learning, change, and multi-tasking is required 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. Careers with Optum. Our objective is to make health care
simpler and more effective for everyone. With our hands at work
across all aspects of health, you can play a role in creating a
healthier world, one insight, one connection and one person at a
time. We bring together some of the greatest minds and ideas to
take health care to its fullest potential, promoting health equity
and accessibility. Work with diverse, engaged and high-performing
teams to help solve important challenges. Colorado, Connecticut,
Nevada or New York City Residents Only: The salary range for
Colorado residents is $18.17 - $32.26. The salary range for
Connecticut / Nevada / New York City residents is $20.00 - $35.53.
Pay is based on several factors including but not limited to
education, work experience, certifications, etc. 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). No matter where or when you
begin a career with UnitedHealth Group, you'll find a far-reaching
choice of benefits and incentives To protect the health and safety
of our workforce, patients and communities we serve, UnitedHealth
Group and its affiliate companies required all employees to
disclose COVID-19 vaccination status prior to beginning employment.
In addition, some roles and locations require full COVID-19
vaccination, including boosters, as an essential job function.
UnitedHealth Group adheres to all federal, state and local COVID-19
vaccination regulations as well as client COVID-19 vaccination
requirements and will obtain the necessary information from
candidates prior to employment to ensure compliance. Candidates
must be able to perform all essential job functions with or without
reasonable accommodation. Failure to meet the vaccination
requirement may result in rescission of an employment offer or
termination of employment. 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: UnitedHealth Group, Los Angeles , Senior Complex Customer Care Representative - National Remote, Other , Los Angeles, California
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