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Turn on the news on any night of the week and you're likely to hear about the changes that are sweeping through our health care system. It's dramatic. It's positive. And it's being led by companies like UnitedHealth Group. Now, you can take advantage of some of the best training and tools in the world to help serve our existing and new customers. You'll take as many as 50-70 calls per day from customers who have questions about their health benefits. As their advocate, you'll use your personality and our tools to help them through the health care benefits available to them, including helping them enroll in a new plan. This is no small opportunity.
Purpose of Job:
The purpose of this role is to interact with members regarding medical and pharmacy benefits, eligibility & claims issues and to assist with plan selection and enrollment. This role is expected to identify opportunities to connect members to the best resources to meet their healthcare needs and provide support in order to resolve medical and benefits issues on behalf of a member. The Customer Service Advocate builds trust with members across their health care lifecycle.
- Provide in language service to Mandarin, Cantonese, and English speaking customers over the phone
- Own problem through to resolution on behalf of the member in real time or through comprehensive and timely follow - up with the member
- Effectively refers and enrolls members to appropriate internal specialists and programs, based on member’s needs and eligibility
- Respond to and resolve on the first call, customer service inquires and issues by identifying the topic and type of assistance the caller needs such as benefits, eligibility and claims, financial spending accounts and correspondence.
- Resolve member service inquiries related to:
- Medical benefits, eligibility and claims
- Terminology and plan design
- Financial spending accounts
- Pharmacy benefits, eligibility and claims
- Correspondence requests
- Educate members about the fundamentals of health care benefits including:
- Managing health and well being
- Maximizing the value of their health plan benefits
- Selecting the best health plan to meet their health needs
- Choosing a quality care provider and appointment scheduling
- Premium provider education and steerage
- Pre - authorization and pre - determination requests and status
- Assist members in appointment scheduling to proactively address gaps in care
- Intervene with care on behalf of the customer to assist with appointment scheduling or connections with internal specialists for assistance when needed
- Research complex issues across multiple databases and work with support resources to own the resolution of all customer issues and anticipate their future healthcare needs or potential opportunities to improve the experience
- Provide education and status on previously submitted pre - authorizations or pre - determination requests
- Meet the performance goals established for the position in the areas of: efficiency, call quality, customer satisfaction, first call resolution and attendance
- Maximizes use of community services, support programs, and resources available to members
- HS Diploma/GED
- Bilingual fluency (verbal and written) in Chinese (both Cantonese and Mandarin) and English
- 1+ years of experience in a professional customer service environment
- The ability upon hire to successfully complete the UnitedHealthcare Operations new hire training with a demonstrated proficiency
- Associate's Degree or higher
- Experience in a Health Care/Insurance environment
- Previous experience in translating healthcare-related jargon and complex processes into simple, step-by-step instructions that customers can understand and act upon
- Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations (responding in respectful, timely manner and delivering on commitments)
- Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests and identify the current and future needs of the member
- Ability to overcome objections and persuade members to take action / change behavior
- Ability to utilize multiple systems / platforms while on a call with a member – strong computer skills and technical aptitude
- Proficient problem solving approach to quickly assess current state and formulate recommendations
- Flexibility to customize approach to meet all types of member communication styles and personalities
- Excellent conflict management skills including:
- Professionally and adeptly resolve issues while under stress
- Diffuse conflict and member distress
- Demonstrate personal resilience
- Strong verbal and written communication skills.
- Solid time management skills
- Strong attention to detail
Careers at UnitedHealthcare Medicare & Retirement. The Boomer generation is the fastest growing market segment in healthcare. And we are the largest business in the nation dedicated to serving their unique health and well-being needs. Up for the challenge of a lifetime? Join a team of the best and the brightest to find bold new ways to proactively improve the health and quality of life of these 9 million customers. You'll find a wealth of dynamic opportunities to grow and develop as we work together to heal and strengthen our Healthcare system. Ready? It's time to do your life’s best work.SM
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: UHG, UHC, customer service, Chinese, Mandarin, Cantonese, bilingual, service advocate