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 UnitedHealthcare, part of the UnitedHealth Group family of businesses. Now, you can take advantage of some of the best training and tools in the world to help serve our members by interfacing and solving issues with their health care providers. As part of our Provider Services group, the quality of support you deliver will directly translate into better care for their patients This is no small opportunity. This is where you can bring your compassion for others while building your career.
- Responsible for answering up to 50 - 70 incoming phone calls per day from both our English speaking and Spanish speaking customers and identify the type of assistance the customer needs
- 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
- Help guide and educate customers about the fundamentals and benefits of consumer-driven health care topics to include managing their health and well - being by selecting the best benefit plan options, maximizing the value of their health plan benefits and choosing a quality care provider
- Intervene with care providers (doctor's offices) on behalf of the customer to assist with appointment scheduling or connections with internal specialists for assistance when needed
- Assist customers in navigating myuhc.com and other UnitedHealth Group websites and encourage and reassure them to become self - sufficient.
- Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow - up with the member
- Research complex issues across multiple databases and work with support resources to resolve customer issues and / or partner with others to resolve escalated issues
- 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
- We are looking for candidates with the following attributes:
- Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations (responding in respectful, timely manners, consistently meeting commitments)
- Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests and identify the current and future needs of the member
- Proficient problem solving approach to quickly assess current state and formulate recommendations
- Proficient in translating healthcare-related jargon and complex processes into simple, step - by - step instructions customers can understand and act upon
- Flexibility to customize approach to meet all types of member communication styles and personalities
- Proficient conflict management skills to include ability to resolve issues in a stressful situation and demonstrating personal resilience
- Ability to work regularly scheduled shifts within our hours of operation, where lunches and breaks are scheduled, with the flexibility to adjust daily schedule, and work over - time and / or weekends, as needed
- 1 year of Call Center experience with inbound calls
- 1 year of experience with Healthcare Claims, Benefits and / or Authorizations (i.e. in a doctor’s office, HMO, etc.)
- Must be bilingual / fluent in English / Spanish
- High school diploma or GED OR 10+ years of equivalent working experience
AppleCare Medical Management Group was incorporated in 2003. Over the last 17 years, the multispecialty medical group of independent practices has expanded into new communities, contracted with more hospitals and health plans, and added over 50 new doctors - but the mission has remained the same. Today, AppleCare Medical Management is comprised of hundreds of board-certified private-practice, independent physicians. Collectively, our physicians have been serving the Southeast area of Los Angeles and Northern Orange County for decades, providing their medical expertise and passion to improving the health of our communities.
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.
Job Keywords: Call Center Associate, Bilingual English / Spanish, La Palma, California, CA, Call Center, Claims examiner, Medical claims, Health plans, Benefits, customer