Even if you have no prior experience, we have training classes starting soon to help you build the successful career that you want - apply today! We provide the support and structure, you provide the interest and motivation.
If you are located within a 50 mile commute to Wausau, you will have the flexibility to telecommute* as you take on some tough challenges. You like working with people. Even more so, you like helping them. This is your chance to join a team dedicated to helping our members and their families every day. In this joint role as a Customer Service and Claims Representative, you'll join us on a mission to not only deliver the best customer service in the health care industry, but the best customer service. Period. Your compassion and customer service expertise combined with our support, training and development will ensure your success. This is no small opportunity. This is where you can bring your compassion for others while doing your life's best work. sm
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
In this role, you play a critical role in creating a quality experience for the callers that you connect with and those that you correspond with. Every interaction gives you that opportunity to improve the lives of our customers and exceed their expectations. You'll spend the majority of your day by responding to calls from our members and help answer questions and resolve issues regarding health care eligibility, claims and payments. You'll also spend a portion of your time reviewing, researching and processing healthcare claims with the goal to ensure that every claim has a fair and thorough review.
To learn even more about this position, click here to watch a short video about the job: http://uhg.hr/CustomerFirstRep (Note: these videos are labeled with our internal job title of Customer First Representatives)
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 to 8pm). It may be necessary, given the business need, to work occasional overtime or weekends. Training and occasional meetings will be conducted onsite. Our office is located at 115 W Wausau Ave, Wausau, WI 54401.
There are several steps in our hiring process. Please make sure that you have filled out all required sections of your employment application. Once you submit your completed application, you will receive an e-mail with information regarding next steps including any pre-employment assessment(s) that are required. Both your application and any required assessment(s) need to be completed before we can consider you for employment so the sooner you complete these two steps, the sooner you will hear from us. To learn more, go to: http://uhg.hr/OurApplicationProcess
- Answer incoming phone calls from customers and identify the type of assistance the customer needs (i.e. benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs)
- Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems
- Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow-up with the member
- Review and research incoming healthcare claims from members and providers(doctors, clinics, etc) by navigating multiple computer systems and platforms and verifies the data/information necessary for processing (e.g. pricing, prior authorizations, applicable benefits)
- Ensure that the proper benefits are applied to each claim by using the appropriate processes and procedures (e.g. claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/certificates)
- Communicate and collaborate with members and providers to resolve issues, using clear, simple language to ensure understanding
- Meet the performance goals established for the position in the areas of: efficiency, accuracy, quality, member satisfaction and attendance
- Previous telecommuting experience preferred
- Prefer 1 year experience in an office setting, call center setting or phone support role, but not required
- An education level of at least a high school diploma or GED OR 10 years of equivalent working experience
- Demonstrated ability in using computer and Windows PC applications, which includes strong keyboard and navigation skills and learning new computer programs
- Ability to multi-task duties as well as the ability to understand multiple products and multiple levels of benefits within each product
- Ability to work regularly scheduled shifts within our hours of operation including the training period, where lunches and breaks are scheduled, with the flexibility to adjust daily schedule, and work over-time and/or weekends, as needed
- All new hires will be required to successful complete the Customer Service training classes and demonstrate proficiency of the material
- Reside within a 50 mile commute to Wausau with the ability to attend training and occasional meetings onsite
- Required to have a dedicated work area established that is separated from other living areas
- Required to have a work area in a section of the residence that provides information privacy
- Required to keep all Company sensitive documents secure
- Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
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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