Position Description: 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.
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 members 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:
1. Medical benefits, eligibility and claims
2. Terminology and plan design
3. Financial spending accounts
4. Pharmacy benefits, eligibility and claims
5. Correspondence requests
Educate members about the fundamentals of health care benefits including:
1. Managing health and well being
2. Maximizing the value of their health plan benefits
3. Choosing a quality care provider and appointment scheduling
4. Pre - authorization 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 resolve customer issues and / or partner with others to resolve escalated issues.
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 member
High School diploma / GED or higher OR 10+ years of equivalent working experience
2+ years in a Customer Service environment or equivalent customer service skills and experience.
Bilingual fluency in Chinese (Cantonese and Mandarin) and English
All new hires will be required to successfully complete the Customer Service training classes and demonstrate proficiency of the material
Proficient in translating healthcare - related jargon and complex processes into simple, step - by - step instructions customers can understand and act upon
Work 40 hours per week. Shift 9:00 am - 5:30 pm EST Monday Friday, may change different shifts as business needs in future; 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 work schedule and work over-time as needed
Associate's or Bachelor's degree or higher
Experience in Health Care / Insurance environment, preferred (Familiarity with medical terminology, health plan documents, or benefit plan design)
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, 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 conflict management skills to include ability to resolve issues in a stressful situation and demonstrating personal resilience
Flexibility to customize approach to meet all types of member communication styles and personalities
Physical Requirements and Work Environment:
Frequent speaking, listening using a headset, sitting, use of hands/fingers across keyboard or mouse, handling other objects, long periods working at a computer
Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.SMDiversity 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, UnitedHealthcare, customer service, call center, inbound, bilingual, chinese, mandarin, Cantonese
See job description.