Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.(sm) Senior Service Account Managers are responsible for first-level response and resolution of escalated issues with external and internal customersPrimary Responsibilities: Manage overall delivery of benefits and services by providing support and guidance to existing and potential customers to ensure continued membership. Provide expertise and customer service support to members, customers, and/or providers Identify and resolves operational problems using defined processes, expertise and judgment Investigate claim and/or customer service issues as identified and communicate resolution to customers Positions in this function are responsible for first-level response and resolution of escalated issues with external and internal customers Responsible for the overall delivery of benefits and services by providing support and guidance to existing and potential customers to ensure continued membership Employees in jobs labeled with SCA must support a government Service Contract Act (SCA) agreement Positions in this function analyzes and investigates and provides explanations and interpretations within area of expertise
High school diploma or GED
2+ years of client account management experience
3+ years of experience with Medicare / Medicaid
1+ years of claims processing experience
Intermediate level of proficiency with MS Word and Excel
UNET, COSMOS, FACETS or NICE claims platforms experience
Project management experience
Bilingual fluency with English and Spanish
Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place 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.
Job Keywords: DSNP Member Advocate, Houston, TX, Texas